What is true about gestational diabetes (GDM)?

MP CHO -2019 (Shift-2)

Obstetrics & Gynaecology

Easy

Appeared in: MP CHO -2019 (Shift-2)

Explanation

Gestational Diabetes Mellitus (GDM) is correctly defined as high blood sugar (hyperglycemia) that is first diagnosed during pregnancy.
The condition arises because hormones produced by the placenta create insulin resistance, which the mother's body may not be able to overcome, leading to elevated glucose levels.
This definition crucially distinguishes GDM from pre-gestational diabetes, where a woman has a diagnosis of diabetes before becoming pregnant.

Option A: This statement describes pre-gestational diabetes, which is a condition where a woman with pre-existing Type 1 or Type 2 diabetes becomes pregnant.
Option B: This is incorrect. The insulin resistance that causes GDM typically begins in the second trimester (around 24-28 weeks) and continues to increase into the third trimester. It is not exclusive to the third trimester.
Option C: This is a false absolute. While diet and exercise are the first-line treatments, a significant number of women with GDM require medication, such as insulin or metformin, to achieve adequate glycemic control.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Definition and characteristics of Gestational Diabetes Mellitus (GDM) as background academic context rather than a clinical decision trigger.
Nurses are central to GDM management, providing essential education on blood glucose self-monitoring, dietary modifications, and exercise regimens.
Uncontrolled GDM poses significant risks, including fetal macrosomia (large baby), which can lead to birth complications like shoulder dystocia, and neonatal hypoglycemia (low blood sugar in the newborn).
What if? If a patient with GDM reports consistent fasting blood glucose levels above 95 mg/dL despite adhering to her diet plan, the nurse should anticipate the healthcare provider initiating medication, most commonly insulin.

How to Approach the Question

First, identify the core of the question: it asks for a 'true' statement about Gestational Diabetes (GDM). This requires recalling the fundamental definition of the condition.
Evaluate each option against the standard medical definition of GDM.
Analyze Option A: 'A diabetic woman conceives.' This describes pre-existing diabetes, not GDM. Eliminate it.
Analyze Option B: '...blood sugar level increases only in the third trimester.' Be wary of absolute words like 'only.' GDM is typically screened for and diagnosed in the second trimester, making this statement incorrect. Eliminate it.
Analyze Option C: 'no medicine needed.' This is another absolute statement. While lifestyle is the first approach, medication is often necessary. This statement is false. Eliminate it.
Analyze Option D: 'High blood sugar occurs during pregnancy.' This is a broad but accurate definition that aligns with the clinical understanding of GDM as hyperglycemia first recognized during gestation. This is the correct answer.

Concept Tested & Keywords

Concept Tested: Definition and characteristics of Gestational Diabetes Mellitus (GDM)
Stem keywords: gestational diabetes, GDM
Lead-in keywords: true about
Negative lead-in flag: false

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