A client with gestational diabetes is prescribed insulin therapy.

The nurse is educating the client on proper insulin administration techniques.

Which of the following instructions should the nurse provide?

The correct answer is choice A. Higher insulin resistance.According to a systematic review of gestational diabetes mellitus (GDM) in Africa, African-Caribbean women have higher insulin resistance than other ethnic groups, which increases their risk of developing GDM.

Insulin resistance is a condition where the body does not respond well to the hormone insulin, which regulates blood sugar levels.

Choice B is wrong because lower birth weight is not associated with GDM in African-Caribbean women.In fact, some studies have found that GDM increases the risk of macrosomia (large for gestational age infants) and higher mean birth weight.

Choice C is wrong because earlier onset of diabetes is not a characteristic of African-Caribbean women with GDM.

GDM is usually diagnosed in the second or third trimester of pregnancy, regardless of ethnicity.However, women with GDM have a higher risk of developing type 2 diabetes later in life.

Choice D is wrong because faster resolution of diabetes is not a characteristic of African-Caribbean women with GDM.Most women with GDM revert to normal glucose metabolism after delivery, but some may have persistent glucose intolerance or diabetes.The risk of developing type 2 diabetes after GDM is also higher for African-Caribbean women than other ethnic groups.

The correct answer is

C. It transports glucose from the bloodstream into the cells for energy production.

Insulin is a hormone that regulates the metabolism of carbohydrates, fats, and proteins.It promotes the absorption of glucose from the blood into cells, where it can be used for energy or stored as glycogen or fat.It also inhibits glucose production and secretion by the liver and stimulates lipogenesis and protein synthesis.Insulin is essential for cell metabolism and low insulin levels can cause catabolism of body fat.

A. It converts glucose into glycogen for storage in the liver and muscles.

This statement is partially true, but not the main role of insulin.

Insulin does stimulate the formation of glycogen from glucose in the liver and muscles, but this is not its primary function.Glycogen is a form of stored glucose that can be mobilized when blood glucose levels are low.Insulin also inhibits the breakdown of glycogen (glycogenolysis) and the synthesis of glucose from amino acids and fatty acids (gluconeogenesis) in the liver.

B. It breaks down glucose into carbon dioxide and water for excretion in the urine and lungs.

This statement is false.

Insulin does not break down glucose, but rather facilitates its uptake by cells.

Glucose is broken down by a process called glycolysis, which produces pyruvate and ATP (energy).

Pyruvate can then enter the Krebs cycle and the electron transport chain to produce more ATP, carbon dioxide and water.Carbon dioxide is exhaled by the lungs and water is excreted by the kidneys.

Insulin has no direct role in these processes.

D. It stimulates glucose synthesis from amino acids and fatty acids in the liver.

This statement is false.

Insulin does not stimulate glucose synthesis, but rather inhibits it.

Glucose synthesis from non-carbohydrate sources, such as amino acids and fatty acids, is called gluconeogenesis.

This process occurs mainly in the liver and is stimulated by glucagon, a hormone that opposes insulin.Gluconeogenesis helps to maintain blood glucose levels when dietary intake or glycogen stores are low.Insulin suppresses gluconeogenesis by inhibiting the enzymes involved in this pathway.