OGT Post-Test Care and Clinical Follow-Up 2 — Questions and Answers
Question 1: Which finding on OGTT follow-up indicates that a previously prediabetic patient has progressed to type 2 diabetes?
- Fasting glucose 110 mg/dL at retest
- 2-hour glucose 155 mg/dL
- Fasting glucose ≥126 mg/dL confirmed on repeat testing (Correct answer)
- HbA1c 5.8%
Correct answer: Fasting glucose ≥126 mg/dL confirmed on repeat testing
A fasting plasma glucose ≥126 mg/dL confirmed on repeat testing meets ADA criteria for diagnosing type 2 diabetes mellitus.
Question 2: A patient with GDM who delivers a healthy baby should be counseled that GDM resolves postpartum but increases risk of:
- Thyroid disease only
- Type 1 diabetes exclusively
- Type 2 diabetes and cardiovascular disease later in life (Correct answer)
- No long-term health risks
Correct answer: Type 2 diabetes and cardiovascular disease later in life
Women with a history of GDM have significantly elevated lifetime risks of type 2 diabetes and cardiovascular disease and require ongoing metabolic surveillance.
Question 3: Which medication is sometimes prescribed after OGTT confirms prediabetes to delay progression to type 2 diabetes?
- Insulin glargine
- Metformin (Correct answer)
- Empagliflozin
- Sitagliptin
Correct answer: Metformin
Metformin is the only pharmacological agent recommended by the ADA for diabetes prevention in high-risk prediabetic individuals when lifestyle intervention is insufficient.
Question 4: After a normal OGTT result in a patient with risk factors (obesity, family history), retesting is generally recommended in:
- 6 months
- 1–3 years (Correct answer)
- 5 years
- No further testing needed
Correct answer: 1–3 years
For asymptomatic adults with risk factors and a normal OGTT, the ADA recommends retesting every 1–3 years based on individual risk profile.
Question 5: Which specialist referral is MOST appropriate for a newly diagnosed gestational diabetes patient?
- Cardiologist
- Certified diabetes educator (CDE) and registered dietitian (Correct answer)
- Endocrinologist only
- Obstetrician only
Correct answer: Certified diabetes educator (CDE) and registered dietitian
A certified diabetes educator and registered dietitian provide the core of GDM management — blood glucose education, medical nutrition therapy, and self-monitoring skills.
Question 6: When should a child or adolescent be considered for OGTT to screen for type 2 diabetes?
- All children at age 10
- Overweight/obese youth with two or more additional risk factors starting at age 10 or onset of puberty (Correct answer)
- Only if symptomatic with polyuria and polydipsia
- Only after a positive HbA1c ≥6.5%
Correct answer: Overweight/obese youth with two or more additional risk factors starting at age 10 or onset of puberty
ADA recommends considering OGTT or fasting glucose testing in overweight/obese youth with two or more risk factors (family history, high-risk ethnicity, signs of insulin resistance) from age 10 or puberty onset.
OGT Post-Test Care and Clinical Follow-Up 2
Which finding on OGTT follow-up indicates that a previously prediabetic patient has progressed to type 2 diabetes?