A nurse is counseling a pregnant woman who has gestational diabetes and wants to know how to prevent type 2 diabetes after delivery.

Which of the following recommendations should the nurse give?

The correct answer is choice A. Nonstress test.A nonstress test is a screening tool that uses fetal heart rate patterns and accelerations as an indicator of fetal well-being.It is commonly performed for pregnant women who have gestational diabetes and are taking oral antidiabetic drugs to monitor the effects of the medication on the baby.

Choice B. Biophysical profile is wrong because it is an ultrasound assessment of the fetal status with an NST.It utilizes ultrasound with EFM to assess five variables: fetal breathing movements, fetal movement, fetal tone, amniotic fluid volume, and fetal heart rate.

Choice C.Amniocentesis is wrong because it is a diagnostic procedure where a needle is inserted through the abdominal wall into the uterine cavity to obtain amniotic fluid and commonly performed for genetic testing, neural tube defects, fetal lung maturity, and hemolytic disease in the fetus or intrauterine infection.

Choice D. Chorionic villus sampling (CVS) is wrong because it is a diagnostic procedure where a needle is inserted through the abdominal wall into the uterine cavity to obtain chorionic villi (placental tissue) and commonly performed for chromosomal, metabolic and DNA testing.It does not test for neural tube defects.

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.