A 26-year-old primigravida at 28 weeks gestation undergoes a 75 g 2-hour oral glucose tolerance test (OGTT). Fasting glucose is 98 mg/dL, 1-hour is 185 mg/dL, and 2-hour is 158 mg/dL. All three values exceed IADPSG thresholds. What is the diagnosis?
Answer and explanation
Correct answer: A. Gestational diabetes mellitus (GDM)
- Step 1: International criteria (IADPSG / WHO) diagnose GDM if any single value meets or exceeds: Fasting >= 92 mg/dL, 1-hour >= 180 mg/dL, or 2-hour >= 153 mg/dL.
- Step 2: Placental lactogen (hPL), cortisol, and progesterone induce progressive maternal peripheral insulin resistance.
- Step 3: First-line management begins with nutritional counseling, dietary modification, and glucose monitoring.
Answer
Gestational diabetes mellitus (GDM).
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