## **Core Concept**
Gestational diabetes mellitus (GDM) is a condition characterized by high blood sugar levels that are first recognized during pregnancy. It is associated with insulin resistance and impaired insulin secretion, often due to pancreatic beta-cell dysfunction. The diagnosis and management of GDM are crucial to prevent complications for both the mother and the fetus.

## **Why the Correct Answer is Right**
The correct answer, , is associated with a condition that is not typically seen in gestational diabetes. In GDM, insulin resistance increases throughout the pregnancy, and there is a relative deficiency of insulin secretion. Ketoacidosis is more commonly associated with type 1 diabetes mellitus, where there is an absolute deficiency of insulin. However, ketoacidosis can occur in GDM but is less common compared to other conditions listed.

## **Why Each Wrong Option is Incorrect**
* **Option A:** is seen in GDM. Women with GDM are at an increased risk of developing type 2 diabetes later in life.
* **Option B:** is seen in GDM. Insulin resistance, a hallmark of GDM, increases throughout pregnancy.
* **Option D:** is seen in GDM. Fetal macrosomia, or a birth weight above the 90th percentile, is a known complication of GDM due to the high glucose levels in the maternal bloodstream.

## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that all pregnant women should be screened for GDM between 24 and 28 weeks of gestation using a glucose challenge test. Early identification and management of GDM can significantly reduce the risk of adverse pregnancy outcomes.

## **Correct Answer:** .