A nurse is conducting a prenatal class for women who have gestational diabetes.

The nurse should inform the women that having gestational diabetes increases their risk of having which of the following complications during pregnancy?

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.

The correct answer is choice B. The woman delivered a baby who weighed 3 kg (6.6 lb) at birth.

This indicates that the interventions were successful because the baby’s weight is within the normal range and not affected by gestational diabetes mellitus (GDM).According to one study, an ideal gestational weight gain (GWG) range for women with GDM is 8-11.9 kg for normal weight, 6-7.9 kg for overweight, and -5-3.9 kg for obesity.

Choice A is wrong because the woman gained less than 10 kg (22 lb) during pregnancy.This may be too low for a normal weight woman and may increase the risk of small for gestational age (SGA) or preterm birth.

Choice C is wrong because the woman had no episodes of hypoglycemia or hyperglycemia during pregnancy.

This may be a result of good blood glucose control, but it does not reflect the outcome of the interventions on the baby’s health.

Choice D is wrong because the woman’s blood glucose levels returned to normal within six weeks after delivery.This may happen in most women with GDM, but it does not indicate the effectiveness of the interventions during pregnancy.