29-year-old primigravid woman at 34 weeks' gestation comes to the physician for a prenatal visit. At 28 weeks, she failed her 50-g, 1-hour oral glucose-loading test. She also failed her follow-up 100-g, 3-hour oral glucose tolerance test, with a normal fasting glucose, but abnormal 1, 2, and 3-hour values. Over the past several weeks, she has maintained good control of her fasting and 2-hour postprandial glucose levels by adhering to the diet recommendations of her physician. She asks the physician what effect her type of diabetes can have on her or her fetus. Which of the following is the most appropriate response?
Gestational diabetes can lead to fetal anomalies
Gestational diabetes is unrelated to future diabetes
ans is C. macrosomia. Gestational diabetes is defined as glucose intolerance that either has its onset or its first recognition during pregnancy. Gestational diabetes is usually diagnosed by means of oral glucose tolerance testing. Patients with gestational diabetes and normal fasting glucose levels have two major risks. The first is fetal macrosomia. Women with gestational diabetes are known to have larger babies, and this creates an increased risk of complications of delivery including shoulder dystocia and cesarean delivery. The second risk is of the eventual development of overt diabetes.