1. Most women revert to normal glucose tolerance post partum
2. Children born to a GDM mother have no increased risk of diabetes mellitus later in life
3. Glucose intolerance develops during second and third trimesters
4. Insulin resistance is related to metabolic changes of pregnancy
Select the correct answer using the code given below :
Gestational Diabetes Mellitus (GDM) — Statement Analysis
The correct answer is 1, 3 and 4, corresponding to Option B.
Evaluating Each Statement
- Statement 1 — Most women revert to normal glucose tolerance postpartum: Correct. GDM is driven by the placental hormones and metabolic changes unique to pregnancy. Once the placenta is delivered, insulin sensitivity returns toward normal in the majority of women, and glucose tolerance testing at 6–12 weeks postpartum is usually normal (though a subset go on to develop overt type 2 diabetes later in life).
- Statement 2 — Children of a GDM mother have no increased risk of diabetes later in life: Incorrect. This statement is factually wrong and should not be included. Offspring exposed to maternal hyperglycemia in utero (fetal hyperinsulinemia / the "Pedersen hypothesis") are at well-documented increased risk of obesity, impaired glucose tolerance, and type 2 diabetes mellitus later in life. Including this statement as "correct" is a medical error.
- Statement 3 — Glucose intolerance develops during the second and third trimesters: Correct. Placental hormones (human placental lactogen, progesterone, cortisol, prolactin) rise progressively and antagonize insulin action as pregnancy advances, so the physiological insulin resistance of pregnancy — and any resulting glucose intolerance — becomes clinically apparent chiefly in the second and third trimesters, which is why screening (e.g., OGTT) is done around 24–28 weeks.
- Statement 4 — Insulin resistance is related to metabolic changes of pregnancy: Correct. Pregnancy is inherently a state of increasing insulin resistance, mediated by placental hormones and increased maternal adiposity, to ensure adequate glucose supply to the fetus. GDM results when maternal pancreatic beta-cell reserve cannot compensate for this physiological insulin resistance.
Conclusion
Statements 1, 3, and 4 are medically accurate descriptions of GDM, while statement 2 is false because offspring of GDM pregnancies carry an increased, not absent, long-term risk of diabetes. Therefore, the correct combination is 1, 3 and 4 (Option B).
Important Questions from Diabetes Mellitus
- A 52-year-old male diabetic presents with recurrent episodes of hypoglycemia. On examination, Pulse : 84 beats/minute, BP : 160/100 mm Hg, Chest and CVS examination unremarkable. Which of the following antihypertensive should be avoided in this patient ?
- Which of the following glucose lowering agent can be given as an injectable drug?
Which of the following findings are seen in Diabetic Retinopathy on fundus examination?
1. Microaneurysm
2. Dot and blot hemorrhage
3. Retinal thickening
4. Neovascularization
Select the correct answer using the code given below:
Which of the following statements are correct with regard to glucose homeostasis?
1. Insulin level rises postprandially.
2. Major portion of postprandial glucose is used by skeletal muscle.
3. Brain uses glucose in an insulin-dependent manner.
4. Glucagon is secreted during exercise.
Select the answer using the code given below :
Consider the following pancreatic hormones :
1. Insulin
2. Islet amyloid polypeptide or amylin
3. Glucagon
4. Somatostatin
Which of the above is/are secreted by beta cells of the pancreatic islets?
