In whom does Gestational diabetes occur?

Appeared in: MP CHO-2018

Explanation

Gestational Diabetes Mellitus (GDM) is defined as diabetes with its first onset or recognition during pregnancy.
The term 'gestational' directly refers to the period of gestation, which is pregnancy.
It arises from an inability to increase insulin secretion adequately to compensate for the insulin resistance that occurs naturally during pregnancy.
While it can affect women of various ages, the defining characteristic is the state of being pregnant, not the age group itself.

Option A: A lactating mother is postpartum (after pregnancy). GDM is, by definition, a condition that occurs during pregnancy. If glucose intolerance continues after delivery, it is no longer termed GDM.
Option B: Adolescents can develop diabetes, most commonly Type 1 or increasingly Type 2, but GDM is specific to pregnancy. An adolescent would only develop GDM if she becomes pregnant.
Option C: The elderly population is at high risk for Type 2 diabetes due to age-related insulin resistance and other factors. GDM is not a condition of the elderly, as it is tied to pregnancy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Definition and target population of Gestational Diabetes Mellitus (GDM) as background academic context rather than a clinical decision trigger.
Screening for GDM is a standard part of antenatal care, typically between 24-28 weeks, to prevent complications for both mother and baby.
Uncontrolled GDM can lead to fetal macrosomia (a baby that is much larger than normal), which increases the risk of birth injuries and the need for a C-section.
Nurses play a crucial role in educating pregnant women about diet, exercise, and blood glucose monitoring to manage GDM effectively.

How to Approach the Question

First, analyze the term 'Gestational diabetes'. The keyword is 'Gestational'.
Recall the medical definition of 'gestation'. It refers to the process or period of developing inside the womb between conception and birth.
Connect this definition to the options provided.
Evaluate each option: 'Lactating mother' is post-pregnancy, 'Adolescent' and 'Elderly' are age groups, not a physiological state.
'Pregnant women' directly matches the definition of gestation.
Therefore, select the option that aligns with the core definition of the term in the question.

Concept Tested & Keywords

Concept Tested: Definition and target population of Gestational Diabetes Mellitus (GDM)
Stem keywords: Gestational diabetes
Lead-in keywords: In whom
Negative lead-in flag: false

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E6 Medicine Davidson Principles Practice 24e p. 1298-1300

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1104-1106

E6 Medicine Harrison 22e Part 2 p. 1125-1127

Practise the full MP CHO-2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.