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).