A 28-Year-Old Pregnant Woman Is Spilling Sugar in Her Urine

A 28-year-old pregnant woman is spilling sugar in her urine. The physician orders a glucose tolerance test, which reveals gestational diabetes. The patient is shocked by the diagnosis, stating that she is conscientious about her health, and asks the nurse what causes gestational diabetes. The nurse should explain that gestational diabetes is a result of what etiologic factor?

A) Increased caloric intake during the first trimester
B) Changes in osmolality and fluid balance
C) The effects of hormonal changes during pregnancy
D) Overconsumption of carbohydrates during the first two trimesters