Question

The patient asks why she wasn't tested for GDM until she was at almost 28 weeks gestation. The Nurse's response should be based on the understanding of which normal physiologic change?

a) Reduced insulin production
b) Placental hormonal changes
c) Increased glucose tolerance
d) Decreased pancreatic function

Answer 1

GDM testing is done around 28 weeks due to placental hormonal changes that lead to insulin resistance and peak during this period, making it the optimal time for detection.

Step-by-step explanation:

The reason why testing for Gestational Diabetes Mellitus (GDM) is not usually conducted until approximately 28 weeks gestation is related to placental hormonal changes. As the placenta grows, it produces more hormones, and some of these hormones can block the action of the mother's insulin, a condition known as insulin resistance. This rise in hormones and subsequent insulin resistance typically begins at the end of the second trimester of pregnancy, around 24 to 28 weeks. Therefore, it is around this time that testing for GDM is most appropriate, as this is when the mother's ability to process sugar may be significantly impacted, and the condition is most likely to be detected.