A 30-year-old woman with diabetes mellitus presents to her physician at 19 weeks’ gestation. She is obese and did not realize that she was pregnant until recently. She also has not been “watching her sugar” lately, but is now motivated to improve her regimen. A dilated ophthalmologic examination shows no retinopathy. An ECG is normal. Urinalysis is negative for proteinuria. Laboratory studies show: * Hemoglobin A 1 c: 10.8% * Glucose: 222 mg/dL * Thyroid-stimulating hormone: 1.0 |iU/mL * Free thyroxine: 1.7 ng/dL * Creatinine: 1.1 mg/dL Q. In which of the following condition the risk of developing it is same In diabetics as the general population:

**Core Concept**
Diabetes mellitus is a metabolic disorder that affects glucose metabolism, often leading to various complications, including an increased risk of certain conditions. The question is asking about a condition where the risk is the same in diabetics as in the general population.

**Why the Correct Answer is Right**
In diabetic patients, the risk of certain conditions is often increased due to chronic hyperglycemia, microvascular damage, and inflammation. However, there are some conditions where the risk is not increased or is the same as in the general population. One such condition is **multiple sclerosis** (MS). MS is an autoimmune disease that affects the central nervous system, and its etiology is not directly related to glucose metabolism or insulin resistance. The pathophysiology of MS involves immune-mediated demyelination and axonal damage, which is not influenced by diabetes.

**Why Each Wrong Option is Incorrect**
* **Option A:** **Hypertension** - Diabetes mellitus is a known risk factor for developing hypertension, as chronic hyperglycemia can lead to endothelial dysfunction, increased sympathetic tone, and renal sodium retention.
* **Option B:** **Gallstones** - Diabetes mellitus is associated with an increased risk of gallstones, likely due to increased cholesterol synthesis, bile stasis, and altered gut motility.
* **Option C:** **Osteoporosis** - Diabetes mellitus can lead to an increased risk of osteoporosis, particularly in women, due to impaired calcium absorption, increased bone resorption, and reduced physical activity.

**Clinical Pearl / High-Yield Fact**
Diabetes mellitus is a complex disorder that affects multiple organ systems, and its complications can be prevented or delayed with proper management, including tight glycemic control, lifestyle modifications, and timely interventions.

**Correct Answer:** D. Multiple sclerosis.

✓ Correct Answer: C. Congenital adrenal hyperplasia