Gestational Diabetes Quiz: Assessment & Management

1. When should insulin therapy be initiated in a patient with gestational diabetes?

At diagnosis for all patients

Only if fasting glucose remains ≥95 mg/dL after 2 weeks of diet and exercise

Only during the third trimester

Never; only metformin is used

2. A woman with gestational diabetes has a postprandial glucose of 180 mg/dL. What is the recommended next step?

Continue current diet; recheck in 1 week

Intensify dietary management and increase exercise

Initiate or adjust insulin therapy

Deliver the baby immediately

3. Which screening test is recommended for all pregnant women to detect gestational diabetes?

Fasting blood glucose only

50-gram glucose challenge test (GCT) at 24-28 weeks

Hemoglobin A1c

Random blood glucose

4. A pregnant patient with gestational diabetes reports symptoms of hypoglycemia. Which symptom is most concerning?

Tremors and diaphoresis

Confusion and altered mental status

Mild headache

Slight hunger

5. How soon after delivery should glucose screening resume for a woman with gestational diabetes?

Immediately postpartum

At 6 weeks postpartum

At 3 months postpartum

At 1 year postpartum

6. A newborn whose mother had gestational diabetes is at increased risk for which condition?

Neonatal hypoglycemia

Respiratory distress syndrome

Hyperbilirubinemia

All of the above

7. Which antidiabetic medication is generally contraindicated in pregnancy due to teratogenic effects?

Insulin

Metformin

ACE inhibitors

Sulfonylureas

8. What is the risk of a woman developing type 2 diabetes after gestational diabetes?

5-10% within 5 years

15-20% within 5 years

30-50% within 10 years

9. A woman with gestational diabetes is in active labor. What glucose level should be maintained to prevent neonatal hypoglycemia?

80-120 mg/dL

120-160 mg/dL

>160 mg/dL

10. Which maternal complication is most associated with gestational diabetes?

Gestational hypertension and preeclampsia

Placental abruption

Amniotic fluid embolism

Peripartum cardiomyopathy

11. Gestational diabetes is defined as glucose intolerance first recognized during which trimester of pregnancy?

First trimester

Second or third trimester

Any trimester before conception

Immediately postpartum

12. A patient with gestational diabetes is referred to dietary counseling. Which macronutrient distribution is typically recommended?

40% carbohydrates, 30% protein, 30% fat

45-50% carbohydrates, 20-25% protein, 25-30% fat

60% carbohydrates, 15% protein, 25% fat

50% carbohydrates, 35% protein, 15% fat

13. Which ethnic groups have the highest risk for gestational diabetes?

Hispanic, Native American, Pacific Islander, and South Asian populations

Caucasian and African American populations only

European descent populations

All ethnic groups have equal risk

14. What is the recommended target fasting blood glucose for a pregnant woman with gestational diabetes?

15. A woman with gestational diabetes should monitor her blood glucose how often?

Once daily

Three to four times daily (fasting and postprandial)

Once weekly

Only during clinic visits

16. Which complication is most commonly associated with poorly controlled gestational diabetes in the fetus?

Intrauterine growth restriction

Fetal macrosomia

Preterm labor

Congenital heart defects

17. What is the primary goal of managing gestational diabetes?

Normalize blood glucose levels to prevent maternal and fetal complications

Prevent postpartum type 2 diabetes only

Reduce maternal weight gain

Ensure insulin therapy throughout pregnancy

18. The oral glucose tolerance test (OGTT) for gestational diabetes screening uses a 75-gram glucose load. What are the diagnostic thresholds (fasting, 1-hour, 2-hour)?

≥90, ≥180, ≥155 mg/dL

≥95, ≥190, ≥165 mg/dL

≥100, ≥175, ≥150 mg/dL

≥85, ≥170, ≥145 mg/dL

19. Which maternal factor is the strongest risk factor for developing gestational diabetes?

Maternal age over 35 years

Pre-pregnancy BMI ≥25 kg/m²

Previous history of gestational diabetes

Caucasian ethnicity

20. What is the recommended fasting blood glucose threshold for diagnosing gestational diabetes using the one-step approach?

≥90 mg/dL

≥95 mg/dL

≥100 mg/dL

≥110 mg/dL

Gestational Diabetes Quiz: Can You Manage It?