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MSRA Gestational Diabetes Quiz: From Diagnosis to Delivery

Updated: Jun 29


  1. Which of the following is the recommended initial screening test for gestational diabetes mellitus (GDM) in a pregnant woman with risk factors, according to NICE guidelines?

Choose one option

  • 0%Fasting plasma glucose

  • 0%50 g Glucose Challenge Test (GCT)

  • 0%HbA1c

  • 0%75 g Oral Glucose Tolerance Test (OGTT)

Correct Answer: ✅ D. 75 g Oral Glucose Tolerance Test (OGTT)

Explanation:

  • NICE guidelines recommend 75 g OGTT at 24–28 weeks for women with GDM risk factors.

Fasting glucose, GCT, HbA1c, and urinalysis are not reliable for GDM screening during pregnancy due to physiological changes that affect their accuracy.


  1. A 30-year-old woman at 26 weeks' gestation is diagnosed with gestational diabetes after a 75 g OGTT. Her fasting glucose is 5.9 mmol/L and 2-hour glucose is 8.2 mmol/L. What is the initial step in management?

Choose one option

  • Start metformin immediately

  • Start insulin therapy

  • Refer for diet and lifestyle modification

  • Begin sulfonylurea therapy

✅ Correct Answer: C. Refer for diet and lifestyle modification

Explanation: First-line management of GDM is dietary and lifestyle modification, including referral to a dietitian. Medication is only added if glucose targets are not met in 1–2 weeks.


  1. What is the recommended fasting glucose target for a pregnant woman being monitored for gestational diabetes?

Choose one option

  • ≤ 5.6 mmol/L

  • ≤ 6.1 mmol/L

  • ≤ 7.0 mmol/L

  • ≤ 5.3 mmol/L

 ✅ Correct Answer: D. ≤ 5.3 mmol/L

Explanation: According to NICE guidance, target fasting glucose for women with GDM is ≤ 5.3 mmol/L to reduce the risk of complications like macrosomia and shoulder dystocia.


  1. A woman who had gestational diabetes controlled with insulin delivers a healthy baby. What is the recommended test to assess for persistent diabetes postpartum?


Choose one option

  • Fasting blood glucose at discharge

  • HbA1c at 2 weeks postpartum

  • 75 g OGTT at 6–13 weeks postpartum

  • Urinalysis at 6 weeks postpartum

✅ Correct Answer: C. 75 g OGTT at 6–13 weeks postpartum

Explanation: NICE recommends a 75 g OGTT between 6–13 weeks postpartum to detect persistent diabetes. If missed, HbA1c can be done after 13 weeks.


  1. When should delivery be planned for a woman with GDM requiring metformin but well controlled?

Choose one option

  • At 37 weeks

  • Between 38+0 and 39+6 weeks

  • At 40+6 weeks

  • After 41 weeks


✅ Correct Answer: B. Between 38+0 and 39+6 weeks

Explanation: NICE recommends early delivery between 38+0 and 39+6 weeks for women requiring medications (metformin/insulin) for GDM, due to increased risk of complications like stillbirth.

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