Diabetes Flashcards
Definition
Metabolic disorder, categorised by hyperglycemia resulting from defects of insulin secretion, insulin action or both. Type one is autoimmune, Type two is a lifestyle.
Gestational Diabetes
Any glucose intolerance with first onset or recognition in pregnancy.
Pathophysiology
Increasing levels of placental hormones such human placental lactogen which is responsible for increasing maternal insulin resistance. If she has a limited reserve of insulin then can become glucose intolerant leading to diabetes.
Risk factors
Family history of diabetes. BMI above 30 Previous macrosomic baby Previous GDM Maternal age above 40 Ethnicity Previous unexplained neonatal death PCOS, SLE
Pregnancy effects on Diabetes
Increased requirement for insulin around weeks 28 after the effects of placental hormones.
Nausea and vomitting affects your ability to control.
Haemodilution causes the woman to have more sudden hypos due to the lack of symptoms therefore not controlling her glucose levels.
Exarcebates other complications of diabetes such as retnopathy.
Diabetes on pregnancy
Increased risk of misarriage due to the risk of abnormalities.
Pre eclampsia, endothelial damage.
infection because of the rise of glucose.
Macrosomia because of increased sugar levels as insulin is a growth hormone.
intrapartum interventions, IOL, C/S.
Symptoms
Polyuria- in getting rid of glucose from the kidneys more water must go with it.
Polyfasia- excessive eating because the glucose is not getting to the organs so no energy.
Excessive thirst.
Complications
Retnopathy, neuropathy, cardiovascular disease, stroke. Endothelial damage.
Treatment
Insulin, Metformin, diet.
Management
Continuity of care Specilist diabetes team Obs review USS scans 28, 32, 36 BP checks SFH Daily glucose monitoring Dietician Colostrum harvesting IOL 37- 39 weeks
