EDAPT DIABETES AND PREGNANCY
Diabetes mellitus type 1 (DM1) or diabetes mellitus type 2 (DM2) that are diagnosed before pregnancy are
known as pregestational diabetes mellitus or pre-existing diabetes mellitus. Gestational diabetes mellitus
refers to diabetes that is diagnosed during the second or third trimester of pregnancy. Diabetes diagnosed in
the first trimester should be considered pregestational diabetes mellitus as women may have undiagnosed
DM2 prior to pregnancy.
What is the difference between pregestational diabetes mellitus and gestational diabetes mellitus? Select all
that apply.
Gestational diabetes mellitus (GDM), just as the name suggests, is diabetes mellitus that only occurs during
pregnancy. It is usually diagnosed in the middle stage of pregnancy. There are greater glucose and insulin
demands on the woman’s body during pregnancy. Some women develop gestational diabetes mellitus (GDM)
as a result.
Recall from previous knowledge about the pathophysiology of diabetes mellitus. Diabetes mellitus type 1
(DM1) or diabetes mellitus type 2 (DM2) that exists before pregnancy is known as pregestational diabetes
mellitus in the context of pregnancy.
A nurse is caring for a client diagnosed with gestational diabetes mellitus. Which of the following, known as
the diagnostic gold standard, helps in confirming gestational diabetes?
A glucose tolerance test (GTT) is routinely done for all women between 24-28 weeks gestation. If the fasting
blood sugar or 1-hour blood sugar is elevated, a follow-up 3-hour GTT is done, which determines the diagnosis
of gestational diabetes mellitus (GDM).
The nurse is caring for a client who is at 30 weeks gestation. During the exam, the nurse finds that the
fundus measures 34 cm. Which term is another way to refer to this finding?
Macrosomia refers to a fetus who is larger than normal for the gestational age. The weeks in gestation should
correlate with the fundal measurement in centimeters, so 34 cm is larger than expected at 30 weeks.
Gestational diabetes mellitus is, just as the name suggests, diabetes mellitus that occurs during pregnancy.
However, to distinguish it from possible pre-existing undiagnosed diabetes, it refers to diabetes that is
diagnosed during the second or third trimester of pregnancy. The development of gestational diabetes results
from the developing fetus increasing the mother’s need for both glucose and insulin, and placental hormones
causing insulin resistance.
Many women develop gestational diabetes without any known risk factors. Some women’s bodies, particularly
those with the following risk factors, are unable to meet this increased demand and develop diabetes mellitus
that extends beyond their pregnancy.
 older than age 25 at the time of pregnancy
 first degree relative with diabetes
 history of gestational diabetes
 high risk ethnic groups (African American, Hispanic, American Indian, Asian American, or Pacific
Islander)
 overweight, obese, or morbidly obese
 history of polycystic ovary syndrome