Diabetes Flashcards
List three risk factors predisposing women with gestational diabetes to later diagnosis of type 2 diabetes.
Age > 35 BMI > 30 Non-white Family history of diabetes PCOS Acanthosis nigricans Steroid use Previous GDM Previous fetal macrosomia
What evidence underlies the recommendation to screen for gestational diabetes?
No good evidence comparing screening vs not screening
Screening recommended based on:
- RCTs that show benefit to treating GDM
- GDM is asymptomatic therefore no good way other than screening to identify cases that would benefit from treatment
On which four outcomes are the recommended thresholds for the OGTT based?
Birth weight > 90 %ile
Primary cesarean
Neonatal hypoglycemia
Umbilical cord C-peptide levels
What is the cut-off to diagnose GDM based on a 50 g GCT?
BG > 11.1 one hour post glucose load
What additional antepartum surveillance would you recommend for a woman with insulin-dependent GDM?
US for growth & amniotic fluid q3-4 weeks after 28 weeks
Weekly NST (or other surveillance) after 36 weeks
More frequent surveillance if comorbid factors present (suboptimal glycemic control, obesity, LGA or SGA fetus, previous stillbirth, GHTN)
How long after betamethasone administration should GDM screening be delayed?
At least one week
Also reasonable to proceed directly to OGTT in this case
