Diabetes Mellitus Q 63 - Gyan Darpan : Learning Portal
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Thursday 7 April 2022

Diabetes Mellitus Q 63

Nurse Shey is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply.
    A. Cakes, candies, cookies, and regular soft drinks should be avoided.
    B. Gestational diabetes increases the risk that the mother will develop diabetes later in life.
    C. Gestational diabetes usually resolves after the baby is born.
    D. Insulin injections may be necessary.
    E. The mother should strive to gain no more weight during pregnancy.
    F. The baby will likely be born with diabetes

Correct Answer: A, B, C, & D.

Gestational diabetes can occur between the 16th and 28th week of pregnancy. If not responsive to diet and exercise, insulin injections may be necessary. Concentrated sugars should be avoided.

Option A: Most carbohydrates are found in starchy or sugary foods. They include bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets. Try to avoid eating simple carbohydrates, such as potatoes, french-fries, white rice, candy, soda, and other sweets. This is because they cause the blood sugar to rise quickly after eating such foods.
Option B: Women with gestational diabetes (GDM) have an increased 35 to 60% risk of developing diabetes mellitus over 10 to 20 years after pregnancy. Gestational diabetes etiology is apparently related to 1) the pancreatic beta-cell dysfunction or the delayed response of the beta cells to the glycemic levels, and 2) the marked insulin resistance secondary to placental hormonal release.
Option C: ADA and ACOG recommend repeating testing every 1 to 3 years for women who developed GDM and had normal postpartum screening results. At 4 to 12 weeks postpartum, the recommendation is to perform a 75g oral glucose tolerance test to rule out the possibility of the development of type 2 diabetes, impaired fasting glucose, or impaired glucose tolerance test.
Option D: Insulin can help achieve an appropriate metabolic control, and it is added to the management if fasting blood glucose is greater or equal to 95 mg/dL, if 1-hour glucose level is greater or equal to 140 mg/dL, or if 2-hour glucose level is greater than 120 mg/dL.
Option E: Weight gain should continue, but not in excessive amounts. The clinical features of gestational diabetes mellitus can be varied. The disproportionate weight gain, obesity, and elevated BMI can be suggestive features. The diagnosis is established by the laboratory screening method at the
Option F: Usually, gestational diabetes disappears after the infant is born. However, diabetes can develop 5 to 10 years after pregnancy. The complications of developing gestational diabetes are categorized as maternal and fetal. The fetal complications include macrosomia, neonatal hypoglycemia, polycythemia, shoulder dystocia, hyperbilirubinemia, neonatal respiratory distress syndrome, increased perinatal mortality, and hypocalcemia.

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