Which data places the client at risk for developing gestational diabetes?

• A. The client has a family history of type 1 diabetes.
• B. The client is 5 feet tall and weighs 129 lb.
• C. The client's previous deliveries were by cesarean section.
• D. The client has a history of gestational diabetes with her previous pregnancy.

Answer: (D)

Understanding gestational diabetes risk begins with recognizing that prior glucose intolerance during pregnancy strongly predicts recurrence. When a client has had gestational diabetes in a previous pregnancy, her body has already shown an inability to handle the insulin resistance of pregnancy, and that tendency often persists, making future pregnancies more likely to develop GDM. This is why a history of gestational diabetes in a prior pregnancy is the data point that places her at risk.

A family history of type 1 diabetes isn’t the same risk signal. Type 1 is an autoimmune condition, and while autoimmune factors influence overall diabetes risk, they don’t specifically predict gestational diabetes, which is driven more by insulin resistance and beta-cell stress during pregnancy. Being 5 feet tall and weighing 129 pounds gives a body size that may be near the overweight range, which can modestly increase risk, but it doesn’t carry the same predictive weight as a proven prior episode of GDM. A cesarean delivery history reflects obstetric history but not GDM risk.