Gestational Diabetes: NCLEX Priorities
GDM: screening 24-28 weeks, diet first, insulin if uncontrolled, macrosomia risk.
Gestational diabetes is glucose intolerance first identified in pregnancy. NCLEX tests screening, management, and complications.
Screening
24-28 weeks. 1-hour 50 g glucose challenge → if abnormal, 3-hour 100 g OGTT.
Management
Diet + exercise first. Insulin if uncontrolled (preferred over orals though metformin used). Self-monitoring fasting + 1-2h postprandial.
Risks
Macrosomia, shoulder dystocia, neonatal hypoglycemia, future T2DM (mother and child). Increased C-section rate.
Postpartum
GDM usually resolves. Screen at 6-12 weeks postpartum with 75 g OGTT, risk T2DM lifelong.
Frequently asked
Why insulin over oral in pregnancy?
Doesn't cross placenta. Strong safety data. Metformin used but data evolving.
Breastfeeding and GDM?
Encouraged. Reduces future T2DM risk for mother and child.
Quick check
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