Antenatal care: gestational diabetes: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Antenatal care: gestational diabetes

Sample item

In India, a single-step test for gestational diabetes can be done at the first antenatal visit irrespective of the time of the last meal, using a 75 g oral glucose load. Which result is diagnostic?

AA 2-hour plasma glucose of 140 mg/dL or moreBA fasting plasma glucose of 70 mg/dLCA random plasma glucose of 120 mg/dLDA 1-hour plasma glucose of 100 mg/dL

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. A 2-hour plasma glucose of 140 mg/dL or more

The DIPSI approach, accepted in Indian programmes, uses a 75 g oral glucose load in the non-fasting state, and a 2-hour plasma glucose of 140 mg/dL or more diagnoses gestational diabetes. It is simple and avoids fasting visits, which is helpful where follow-up is difficult. Women are tested at the first contact and again at 24 to 28 weeks if the first test is normal.

Option by option

A. A 2-hour plasma glucose of 140 mg/dL or more (correct)
Correct. A 2-hour value of 140 mg/dL or more after the 75 g load is diagnostic.
B. A fasting plasma glucose of 70 mg/dL
A fasting value of 70 mg/dL is normal.
C. A random plasma glucose of 120 mg/dL
A random value of 120 mg/dL does not meet the diagnostic threshold.
D. A 1-hour plasma glucose of 100 mg/dL
A 1-hour value of 100 mg/dL is normal and is not the criterion here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, A 2-hour plasma glucose of 140 mg/dL or more. The DIPSI approach, accepted in Indian programmes, uses a 75 g oral glucose load in the non-fasting state, and a 2-hour plasma glucose of 140 mg/dL or more diagnoses gestational diabetes.

Why is "A fasting plasma glucose of 70 mg/dL" not the answer?

A fasting value of 70 mg/dL is normal.

Why is "A random plasma glucose of 120 mg/dL" not the answer?

A random value of 120 mg/dL does not meet the diagnostic threshold.

Why is "A 1-hour plasma glucose of 100 mg/dL" not the answer?

A 1-hour value of 100 mg/dL is normal and is not the criterion here.

What concept does this question test?

It tests Antenatal care: gestational diabetes in OBG. It is simple and avoids fasting visits, which is helpful where follow-up is difficult. Women are tested at the first contact and again at 24 to 28 weeks if the first test is normal.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antenatal care: gestational diabetes?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.