3-2-16-Gestational Diabetes (Kirila)

Question 1

Blood glucose of 100-125 is termed ____

Answer 1

Impaired Fasting Glucose (IFG)

Question 2

Blood glucose of 140-199 is known as ___

Answer 2

Impaired Glucose Tolerance (IGT)–> After glucose challenge

Question 3

Screening for GDM should occur at about weeks ___ gestation

Answer 3

24-28

Question 4

Describe the 2 step approach for GDM screening in the US:

Answer 4

• Screen with 50 gm oral glucosa challenge with single plasma glucose drawn at 1 hour (less than 130 is normal)
• If greater than 130, proceed with 100 g oral glucose challenge in a fasting state (no caloric intake for at least 8 hrs prior to test)

Question 5

___ is a new onset of HTN (>140/90) and proteinuria after 20 weeks gestation

Answer 5

Preeclampsia

Question 6

___ is excess amniotic fluid in the uterus

Answer 6

Hydramnios

Question 7

List possible fetal complications related to GDM:

Answer 7

• Shoulder dystocia
• Brachial plexus injury
• Birth trauma–> contusions, large hematoma from vacuum extraction, hypoxia/acidosis
• Increased long term risk of obesity and metabolic syndrome

Question 8

List risk factors for GDM:

Answer 8

• Maternal obesity –> pre-pregnancy weight 110% or more of ideal body weight or BMI over 30 kg/m2
• Maternal age (over 25)
• Previous delivery of baby larger than 9 lbs
• History of unexplained perinatal loss or malformation
• Family history of diabetes-especially 1st degree relatives
• Glycosuria at 1st pre-natal visit
• Metabolic syndrome
• Polycystic ovarian syndrome (PCOS)
• HTN
• Glucocorticoid use at time of pregnancy
• Ethnicity (Hispanic, AA’s, NA’s, south or east asian, pacific islander)