Medical disorders in pregnancy: gestational diabetes treatment: 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 · Medical disorders in pregnancy: gestational diabetes treatment

Sample item

A woman with gestational diabetes has fasting plasma glucose above target despite 2 weeks of diet therapy. What is the preferred next step?

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

The answer and the reasoning

C. Start insulin (or metformin where acceptable)

Medical nutrition therapy is the first step; if targets are not met (fasting below 95 mg/dL, 1-hour below 140, 2-hour below 120) pharmacotherapy is started. Insulin does not cross the placenta and remains the standard, with metformin an accepted alternative in India. Delivery is usually planned at 38 to 39 weeks.

Option by option

  • A. Start glibenclamide in the first trimester

    Sulfonylureas are less preferred and not first-line in the first trimester.

  • B. Stop dietary treatment

    Diet should continue alongside drugs.

  • C. Start insulin (or metformin where acceptable) (correct)

    Correct. Insulin or metformin is added when diet fails.

  • D. Induce labour at 34 weeks

    Early induction is unnecessary in the absence of complications.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Start insulin (or metformin where acceptable). Medical nutrition therapy is the first step; if targets are not met (fasting below 95 mg/dL, 1-hour below 140, 2-hour below 120) pharmacotherapy is started.

Why is "Start glibenclamide in the first trimester" not the answer?

Sulfonylureas are less preferred and not first-line in the first trimester.

Why is "Stop dietary treatment" not the answer?

Diet should continue alongside drugs.

Why is "Induce labour at 34 weeks" not the answer?

Early induction is unnecessary in the absence of complications.

What concept does this question test?

It tests Medical disorders in pregnancy: gestational diabetes treatment in OBG. Insulin does not cross the placenta and remains the standard, with metformin an accepted alternative in India. Delivery is usually planned at 38 to 39 weeks.

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 Medical disorders in pregnancy: gestational diabetes treatment?

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.