A 28-year-old G2P1 at 26 weeks has a 75 g oral glucose tolerance test (OGTT). Results: fasting glucose 94 mg/dL, 1-hour glucose 198 mg/dL, 2-hour glucose 165 mg/dL. How should she be managed?
- A Normal result; no intervention needed
- B Gestational diabetes mellitus; medical nutrition therapy and glucose monitoring ✓
- C Pregestational diabetes mellitus; start insulin immediately
- D Repeat OGTT in 4 weeks to confirm
Correct answer: B. Gestational diabetes mellitus; medical nutrition therapy and glucose monitoring
Explanation
Using the WHO/IADPSG 2010 criteria (adopted in India and ACOG), gestational diabetes mellitus is diagnosed when any one value meets or exceeds: fasting ≥92 mg/dL, 1-hour ≥180 mg/dL, or 2-hour ≥153 mg/dL. This patient has an elevated fasting (94) and 2-hour (165) value, confirming GDM. Initial management is medical nutrition therapy with glucose self-monitoring; if targets are not achieved in 1–2 weeks, insulin therapy is added. Oral hypoglycemics (metformin, glyburide) may be used as second-line.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.