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The glucose challenge test does not confirm GDM. It is a screening method. Diagnosis requires a 3-hour oral glucose tolerance test using 100 grams of glucose, with specific thresholds at fasting, 1 hour, 2 hours, and 3 hours. Confirmation needs at least 2 abnormal values.

The 50-gram glucose challenge test is not a fasting test. It is performed regardless of the last meal. Fasting glucose is measured separately and is not part of this screening. The test evaluates post-load glucose handling, not baseline glucose levels.

The test does not assess fetal growth. Fetal macrosomia is a consequence of poorly controlled GDM, but growth is monitored via ultrasound, not glucose challenge testing. The test evaluates maternal glucose metabolism, not fetal parameters.

A value of 155 mg/dL is not normal. The cutoff for normal in the 50-gram challenge is <140 mg/dL. Reassurance without further testing risks missing subclinical hyperglycemia, which can lead to fetal complications if untreated.

Insulin therapy is not initiated based on screening results alone. Treatment begins only after confirmed diagnosis via the 3-hour oral glucose tolerance test. Premature insulin use may cause iatrogenic hypoglycemia and lacks diagnostic justification.

Dietary modifications are part of GDM management but not initiated at the screening stage. Without diagnostic confirmation, advising carbohydrate restriction is premature and may lead to nutritional imbalance in pregnancy.

Screening at delivery is clinically irrelevant. By this time, undiagnosed GDM may have already caused fetal complications such as macrosomia or shoulder dystocia. Screening must occur early to allow for glycemic control during pregnancy.

Screening at 32 weeks is too late. GDM typically develops between 24 and 28 weeks due to rising placental hormones. Delayed screening increases risk of uncontrolled hyperglycemia and adverse outcomes. Early identification is critical in high-risk populations.

Postpartum screening is used to assess resolution of GDM or detect persistent type 2 diabetes. It is not appropriate for initial screening. During pregnancy, undiagnosed GDM can lead to neonatal hypoglycemia and maternal complications, making early screening essential.

The 50-gram, 1-hour glucose challenge test is used for screening during pregnancy, not postpartum. It lacks diagnostic precision and does not provide fasting or 2-hour values. It cannot detect persistent glucose intolerance after delivery.

Fasting plasma glucose alone may miss cases of impaired glucose tolerance. While useful, it lacks post-load assessment, which is critical for identifying subtle abnormalities in glucose metabolism. It has lower sensitivity compared to the 2-hour OGTT.

Hemoglobin A1c reflects average glucose over 2 to 3 months but is less sensitive in the postpartum period due to rapid changes in glucose metabolism. It may miss early glucose dysregulation and is not recommended as a sole screening tool.