Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Incidence of any type of diabetes in pregnancy

A

7% of all pregnancies, (86% of those cases are GDM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

GDM is associated with what risks?

A
  • Developing preeclampsia
  • Having a c/s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What percentage of GDM patient will develop T2DM within 22-28 years after pregnancy?

A

70%!!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fetal risks when mom has GDM?

A
  • Macrosomia
  • Neonatal hypoglycemia
  • Hyperbilirubinemia
  • Shoulder dystocia
  • Birth trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is GDM screening?

A

24-28 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the screening test for GDM?

A

1 hour glucose GCT (50 g)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

1 hour 50 g GCT cut off

A

130-140 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Carpenter and Coustan cutoff for 3 hour GTT

A

Fasting 95
1 hour 180
2 hour 155
1 hour 140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is a woman still at increased risk of adverse perinatal outcomes if she only has 1 abnormal value on 3 hr GTT?

A

Yes!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How often should GDM patients check their blood sugar?

A

AM Fasting and 1-2 hours post prandial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Goals for blood glucose of GDM patient’s?

A

Fasting < 95
1 hour post prandial < 140
2 hour post prandial < 120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment for GDM

A
  1. Lifestyle- diet and exercise
  2. Insulin
  3. Metform
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Typical starting dose for insulin for GDM?

A

0.7-1 unit/kg daily - divided among multiple injections using long and short acting insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Does insulin cross the placenta?

A

Nope!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Short acting insulins

A

Lispro
Aspart

Onset- 1-15 minutes
Peak action at 1-2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Long acting insulins

A

NPH
Glargine (lantus)
Determir

Onset 1-3 hours

17
Q

MOA of metoformin

A

Biguanide

Inhibits hepatic gluconeogenesis and glucose absorption and stimulated glucose uptake in peripheral tissues

18
Q

Does metformin cross the placenta?

A

Yes! Levels can be as high as maternal concentrations

19
Q

If on metformin for PCOS when should you discontinue metformin?

A

After frist trimester??

Limited evidence to suggest a decrease risk of adverse pregnancy outcomes (including first trimester loss)

20
Q

Counseling for Metformin in treating GDM?

A
  1. Lack of superiority when compared with insulin
  2. It crosses placenta!
  3. Absence of long-term data in exposed offspring
21
Q

Dosage for Metformin for GDM?

A

500 mg nightly for 1 week, then increase to twice daily

Max dose: 2500-3000 mg/day

**Check Creatinine!

22
Q

Fetal surveillance for GDM either poorly controlled or on medications?

A

Antenatal testing starting at 32 weeks

no consensus regarding antenatal testing in GDMA1

23
Q

What fluid abnormality can be seen in babies w/ GDM moms?

A

Polyhydramnios

Results from fetal hyperglycemia.

Can incorporate serial measures of amniotic fluid

24
Q

Delivery of GDM patients

A

Good control, no other complications = term

Good control + medical therapy = 39 weeks

Poor control = 37 weeks

25
Q

In GDM patients, c/s is recommended for what EFW?

A

4,500 g

5,000 g for non-GDM

26
Q

Postpartum screening for GDM

A

12 weeks postpartum

Fasting glucose and 75 g 2 hour GTT

27
Q

Early labor glucose checks for GDM?

A

AC, QHS (before meals and at night)

or

Q4 hours

28
Q

Active labor glucose checks for GDM?

A

q1-2 hours

insulin drip + D5 if high blood glucose

29
Q

Screening for pre-gestational diabetes..

Who needs it?

A

Early 1 hour GCT

Obesity BMI >/= 30
Prior macrosomia/SD/Stillbirth/GDM
PCOS
Fm Hx of diabetes
Hyperlipidemia
Physical inactivity
Hx of CVD

30
Q

Pre gestational Diabetes RISKS

A

Miscarriage
IUFD
IUGR, macrosomia
PTD
Congenital anomalies

31
Q

What type of congenital anomalies are associated with pre gestational diabetes?

A

Caudal regression (sacral agenesis)
Cardiac anomalies (ASD, VSD, Transposition)
Neural Tube Defects (spina bifida, anencephaly)

32
Q

Are there increased risks of fetal congenital anomalies for GDM?

A

Nope!!

(Risks of macrosmia, SD, hyperbilirunemia, etc but NOT congenital heart defects, etc)

33
Q

Patient screens positive for pre gestational diabetes? Next steps?

A
  1. Referral to diabetes ed
  2. Start checking BG
  3. Start ASA 81 mg for Pre E PPx
  4. Detailed anatomy scan + fetal ECHO
  5. Antenatal Surveillance

Obstetrics (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions