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Gestational diabetes — MCCQE Part 1 MCQ

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ModeratePregnancyGestational diabetesMCCQE Part 1

A 31-year-old woman at 26 weeks' gestation has a 50 g glucose challenge test result of 10.1 mmol/L. She has a family history of type 2 diabetes and previous macrosomic infant. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Diagnostic 75 g oral glucose tolerance test

An abnormal screening glucose challenge in pregnancy should be followed by diagnostic oral glucose tolerance testing according to the local Canadian approach. HbA1c is not sufficiently sensitive as a sole diagnostic test for gestational diabetes. Urine glucose is unreliable. Waiting until postpartum would miss an opportunity to reduce maternal and neonatal complications.

Reference: Diabetes Canada pregnancy guideline; SOGC diabetes in pregnancy guidance