A nurse is reviewing the medical records of four pregnant women who are being screened for gestational diabetes.

Which of the following women has the highest risk factor for developing gestational diabetes?

The correct answer is choice D. Macrosomia.Macrosomia is a condition where the baby grows larger than normal due to excess sugar from the mother’s blood.This can lead to complications such as injuries during delivery, low blood sugar and mineral levels, jaundice, pre-term birth, and breathing problems for the baby.It can also increase the risk of obesity and diabetes later in life for the baby.

Choice A is wrong because intrauterine growth restriction (IUGR) is a condition where the baby grows smaller than normal due to poor nutrition or oxygen supply from the placenta.

Gestational diabetes does not cause IUGR, but other factors such as high blood pressure, smoking, infections, or chromosomal abnormalities can.

Choice B is wrong because respiratory distress syndrome (RDS) is a condition where the baby has difficulty breathing due to immature lungs that lack surfactant, a substance that helps keep the air sacs open.

Gestational diabetes does not directly cause RDS, but it can increase the risk of pre-term birth, which is a major risk factor for RDS.

Choice C is wrong because congenital anomalies are structural or functional defects that are present at birth due to genetic or environmental factors.

Gestational diabetes does not cause congenital anomalies, but it can increase the risk of them if it is present before or during early pregnancy, when the baby’s organs are forming.

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.