NM706 Exam 3 Questions and Answers Solved Correctly Rated A+
How does pregnancy increase the risk of gestational diabetes (GDM)? - Answers Pregnancy hormones
(hPL → progesterone + cortisol + growth hormone) → support ↑ glucose levels in mom for baby but
they also cause INSULIN RESISTANCE
What are risk factors for GDM? - Answers -overweight/obese
-BMI >25
-1st degree relative with DM
-AA, Latino, Native, Asian/PI
-Hx infant >4000g
-Hx GDM
-HTN
-Hyperlipidemia
-PCOS
According to ACOG, who requires early screening for GDM? - Answers -overweight/obese
-BMI >25
-1st degree relative with DM
-AA, Latino, Native, Asian/PI
-Hx infant >4000g
-Hx GDM
-HTN
-Hyperlipidemia
-PCOS
What are the maternal implications of GDM (short and long term)? - Answers Pre-E during preg
Increased r/o c/s
T2DM later in life
,What are the fetal and newborn implications of GDM? - Answers -Fetal LGA/macrosomia
-Shoulder dystocia/birth injuries
-polycythemia
-hyperbilirubinemia
-RDS
-NICU admission
-neonatal hypoglycemia
What patients are eligible for selective GDM screening? - Answers -Age <25
-Not Hispanic, AA, Native, Asian/PI
-BMI 25 or less
-No hx abnormal GTT
-No hx of adverse OB outcomes
-No 1st degree relative with DM
What is the rationale for universal GDM screening? - Answers -GDM typically does not present with
symptoms; therefore, to reduce maternal and fetal complications, women must be screened for GDM to
diagnose and initiate management
When is the 50-g GDM screening used? - Answers -50 g used for 1 hr GTT
-*Non fasting*
-Used for early screening and routine 24-28 wk
When is the 100-g GDM screening used? - Answers Used for 3 hr GTT following elevated 1 hr result
(Fasting, 1, 2, and 3 hr)
When is the 75-g GDM screening used? - Answers -Used for 2 hr GTT
(Fasting, 1 and 2 hr)
-Early screening and routine 24-28 wk
What is the GDM two-step testing approach? - Answers Most widely used method in US:
-1 hr glucose after 50 g load
, -If 1 hr is abnormal, f/u with 3 hr 100g GTT
What is the GDM one-step testing approach? - Answers 2 hr 75 g GTT
What is the threshold value for a 1-hr, 50g GDM screening? - Answers 130-140 depending on institution
What are the threshold values for a 3-hr, 100g GDM screening? - Answers
What is the Carpenter/Coustan scale? - Answers designates lower blood glucose values to diagnose =
more women are diagnosed with GDM
-Fasting: >95
-1-hour: >180
-2-hour: >155
-3-hour: >140
What is the NDDG scale? - Answers uses higher levels to diagnose
-Fasting >105
-1 hr >190
-2 hr >165
-3 hr >145
Why does ACOG support a two-step testing versus one-step testing? - Answers because of the large
proportion of women who had negative early pregnancy screening but who will go on to develop GDM
How is GDM diagnosed in the pregnant patient? - Answers -Failed 1 hr GTT
-2+ thresholds in the 3 hr GTT met or exceeded
What is the first-line management of GDM? - Answers Diet and exercise
When are diet and exercise indicated in GDM management? - Answers as the 1st line management
When is blood sugar monitoring indicated in GDM management? How many times a day should a
patient monitor their blood sugar? - Answers 4x day
Fasting plus 1 or 2 hr postprandial
What is the fasting threshold value in patient with GDM? - Answers <95
What is the 1-hr postprandial threshold value in a patient with GDM? 2 hour? - Answers <140
<120
How does pregnancy increase the risk of gestational diabetes (GDM)? - Answers Pregnancy hormones
(hPL → progesterone + cortisol + growth hormone) → support ↑ glucose levels in mom for baby but
they also cause INSULIN RESISTANCE
What are risk factors for GDM? - Answers -overweight/obese
-BMI >25
-1st degree relative with DM
-AA, Latino, Native, Asian/PI
-Hx infant >4000g
-Hx GDM
-HTN
-Hyperlipidemia
-PCOS
According to ACOG, who requires early screening for GDM? - Answers -overweight/obese
-BMI >25
-1st degree relative with DM
-AA, Latino, Native, Asian/PI
-Hx infant >4000g
-Hx GDM
-HTN
-Hyperlipidemia
-PCOS
What are the maternal implications of GDM (short and long term)? - Answers Pre-E during preg
Increased r/o c/s
T2DM later in life
,What are the fetal and newborn implications of GDM? - Answers -Fetal LGA/macrosomia
-Shoulder dystocia/birth injuries
-polycythemia
-hyperbilirubinemia
-RDS
-NICU admission
-neonatal hypoglycemia
What patients are eligible for selective GDM screening? - Answers -Age <25
-Not Hispanic, AA, Native, Asian/PI
-BMI 25 or less
-No hx abnormal GTT
-No hx of adverse OB outcomes
-No 1st degree relative with DM
What is the rationale for universal GDM screening? - Answers -GDM typically does not present with
symptoms; therefore, to reduce maternal and fetal complications, women must be screened for GDM to
diagnose and initiate management
When is the 50-g GDM screening used? - Answers -50 g used for 1 hr GTT
-*Non fasting*
-Used for early screening and routine 24-28 wk
When is the 100-g GDM screening used? - Answers Used for 3 hr GTT following elevated 1 hr result
(Fasting, 1, 2, and 3 hr)
When is the 75-g GDM screening used? - Answers -Used for 2 hr GTT
(Fasting, 1 and 2 hr)
-Early screening and routine 24-28 wk
What is the GDM two-step testing approach? - Answers Most widely used method in US:
-1 hr glucose after 50 g load
, -If 1 hr is abnormal, f/u with 3 hr 100g GTT
What is the GDM one-step testing approach? - Answers 2 hr 75 g GTT
What is the threshold value for a 1-hr, 50g GDM screening? - Answers 130-140 depending on institution
What are the threshold values for a 3-hr, 100g GDM screening? - Answers
What is the Carpenter/Coustan scale? - Answers designates lower blood glucose values to diagnose =
more women are diagnosed with GDM
-Fasting: >95
-1-hour: >180
-2-hour: >155
-3-hour: >140
What is the NDDG scale? - Answers uses higher levels to diagnose
-Fasting >105
-1 hr >190
-2 hr >165
-3 hr >145
Why does ACOG support a two-step testing versus one-step testing? - Answers because of the large
proportion of women who had negative early pregnancy screening but who will go on to develop GDM
How is GDM diagnosed in the pregnant patient? - Answers -Failed 1 hr GTT
-2+ thresholds in the 3 hr GTT met or exceeded
What is the first-line management of GDM? - Answers Diet and exercise
When are diet and exercise indicated in GDM management? - Answers as the 1st line management
When is blood sugar monitoring indicated in GDM management? How many times a day should a
patient monitor their blood sugar? - Answers 4x day
Fasting plus 1 or 2 hr postprandial
What is the fasting threshold value in patient with GDM? - Answers <95
What is the 1-hr postprandial threshold value in a patient with GDM? 2 hour? - Answers <140
<120
