Diabetes Education Certification Pregnancy & Gestational Diabetes 2 — Questions and Answers
Question 1: Which glucose monitoring approach is strongly recommended for women with type 1 diabetes during pregnancy?
- A1C testing every 6 weeks
- Weekly fasting glucose checks only
- Continuous glucose monitoring (CGM) (Correct answer)
- Monthly oral glucose tolerance tests
Correct answer: Continuous glucose monitoring (CGM)
CGM is strongly recommended in type 1 diabetes during pregnancy because it reduces A1C, hypoglycemia, and large-for-gestational-age births.
Question 2: What is the ADA-recommended A1C target during pregnancy for women with preexisting diabetes (when achievable without significant hypoglycemia)?
- <5.5%
- <6.0%
- <6.5% (Correct answer)
- <7.0%
Correct answer: <6.5%
ADA recommends an A1C <6.5% during pregnancy for women with preexisting diabetes when achievable without clinically significant hypoglycemia.
Question 3: Which oral antidiabetic agent is most studied and sometimes used in pregnancy for GDM when insulin is not accepted by the patient?
- Sitagliptin
- Canagliflozin
- Metformin (Correct answer)
- Glipizide
Correct answer: Metformin
Metformin has the most pregnancy safety data among oral agents and may be used when insulin is refused, though insulin remains the preferred pharmacotherapy.
Question 4: What neonatal complication must be monitored for immediately after delivery in infants born to mothers with poorly controlled GDM?
- Neonatal hyperglycemia
- Neonatal hypoglycemia (Correct answer)
- Neonatal hyperkalemia
- Neonatal hyperthyroidism
Correct answer: Neonatal hypoglycemia
Fetal hyperinsulinemia persists after birth; once the maternal glucose supply is cut, continued insulin secretion causes neonatal hypoglycemia.
Question 5: At what postpartum time frame should women who had GDM be retested for persistent diabetes or prediabetes?
- 2 weeks postpartum
- 4–12 weeks postpartum (Correct answer)
- 6 months postpartum
- 12 months postpartum
Correct answer: 4–12 weeks postpartum
ADA recommends retesting at 4–12 weeks postpartum with a 75g OGTT to identify women who have persistent dysglycemia after GDM.
Question 6: Which pregnancy-specific hypertensive disorder is significantly more common in women with gestational diabetes?
- Gestational anemia
- Preeclampsia (Correct answer)
- Hyperemesis gravidarum
- Placenta previa
Correct answer: Preeclampsia
GDM is associated with a markedly elevated risk of preeclampsia due to the vascular and metabolic effects of insulin resistance.
Question 7: Which dietary approach is the cornerstone of medical nutrition therapy for gestational diabetes?
- Very low carbohydrate ketogenic diet (<50g/day)
- Carbohydrate-controlled diet with consistent carbohydrate distribution at each meal (Correct answer)
- High-protein diet with unrestricted fat intake
- Equal macronutrient distribution regardless of postprandial glucose response
Correct answer: Carbohydrate-controlled diet with consistent carbohydrate distribution at each meal
GDM nutrition therapy emphasizes consistent, controlled carbohydrate intake distributed evenly across meals to minimize postprandial glucose excursions.
Diabetes Education Certification Pregnancy & Gestational Diabetes 2
Which glucose monitoring approach is strongly recommended for women with type 1 diabetes during pregnancy?