Pregnancy & Gestational Diabetes Flashcards

At what gestational week is universal screening for gestational diabetes mellitus (GDM) typically recommended?

Answer: 24–28 weeks

Universal GDM screening is performed at 24–28 weeks gestation when placental hormones peak and cause maximal insulin resistance.

Which test is used in the one-step approach to GDM screening recommended by the IADPSG?

Answer: 75g oral glucose tolerance test (OGTT)

The IADPSG one-step approach uses a 75g OGTT with plasma glucose measured fasting, at 1 hour, and at 2 hours.

What is the IADPSG fasting plasma glucose threshold for diagnosing gestational diabetes?

Answer: 92 mg/dL

The IADPSG diagnostic criterion for GDM is a fasting plasma glucose ≥92 mg/dL, which is lower than the traditional ADA threshold.

Poorly controlled GDM most directly causes which fetal complication?

Answer: Macrosomia

Maternal hyperglycemia causes fetal hyperinsulinemia, promoting excessive fat and glycogen deposition that results in macrosomia.

What is the ADA-recommended fasting blood glucose target for women with gestational diabetes?

Answer: <95 mg/dL

ADA recommends a fasting glucose of <95 mg/dL in GDM to reduce the risk of macrosomia and other perinatal complications.

Women who have had gestational diabetes have an increased lifetime risk of developing which condition?

Answer: Type 2 diabetes mellitus

Women with a history of GDM have a 35–60% lifetime risk of developing type 2 diabetes, reflecting underlying insulin resistance.

Which long-acting insulin has the strongest evidence supporting its safety and efficacy as a basal insulin during pregnancy?

Answer: Insulin detemir

Insulin detemir (Levemir) has the most robust randomized trial data supporting its safety and efficacy for basal insulin therapy during pregnancy.