Diabetes Flashcards

1
Q

What are the criteria for a diagnosis of gestational diabetes?

A

Fasting glucose =/> 5.6mmol/litre

2 hour plasma glucose level =/>7.8mmol/litre

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2
Q

What Hba1c should diabetics who are trying to get pregnant aim for?

A

48mmol/litre (6.5%)

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3
Q

At what Hba1c level would you advise a diabetic women against getting pregnant?

A

86mmol/litre (10%)

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4
Q

How common is gestational diabetes?

A

It occurs in 2-5% of pregnancies

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5
Q

What proportion of pregnancies are associated with diabetes?

A

5%

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6
Q

What are the different causes of diabetes in pregnancy?

A

Gestational 87.5%
Type 1 7.5%
Type 2 5%

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7
Q

Advisable pre-conception fasting glucose

A

5-7 on waking

plasma glucose 4-7 before meals

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8
Q

What are the target glucose levels for pregnant women with diabetes?

A

fasting 5.3
1 hour post meal 7.8
2 hours post meal 6.4

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9
Q

What should you test at 16 weeks for patients with diabetes in pregnancy?

A

diabetic retinopathy

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10
Q

What imaging should you request for patients with diabetes in pregnancy?

A

20 week fetal anomaly scan, 28, 32 and 36 week fetal growth and amniotic fluid volume

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11
Q

When is the latest date you would advise a patient with gestational diabetes to give birth?

A

40weeks+6days

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12
Q

When would you induce type 1 and type 2 diabetics?

A

Between 37+0 and 38+6 weeks

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13
Q

When should you test for diabetes in a gestational diabetic patients postnatally?

A

6-13 weeks postnatally with fasting glucose

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14
Q

When should pregnant women at high risk be tested for gestational diabetes?

A

OGTT at 24-28weeks, diagnosis = 7.8 or above

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15
Q

When should metformin be offered in gestational diabetes?

A

If targets not met within 1-2 weeks of trial with diet and lifestyle alone

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16
Q

When would you automatically give insulin +/- metformin?

A

IF fasting glucose is >7 at diagnosis or 6-6.9 if there is also macrosomia or hydramnios

17
Q

When would glibenclamide be considered?

A

patient cannot tolerate metformin or declines insulin