Diabetes in pregnancy Flashcards
how should a type 1 or 2 diabetes patient be prepared pre-pregnancy?
Pre-pregnancy Counseling
o good sugar control pre-conception
o limit risk of congenital malformation
Folic Acid 5mg (not 400ug as in nonDM pregnancy)
Consider change from tablets to insulin (many of the tablets are contraindicated)
what should be monitored throughout pregnancy in type 1 and 2 diabetes patients?
Regular eye checks (10/(20)/30wks gestation) – accelerated retinopathy
Monitor BP
Monitor HbA1c
Use Continuous glucose monitoring
blood sugar targets for mothers with type 1 and type 2 diabetes in pregnancy?
o pre-meal <4- 5.5 mmol/l
o 2h post meal <6-6.5 mmol/l
how should BP be managed in pregnancy for type 1 and 2 diabetes patients?
- Avoid ACEI and probably avoid Statin – for BP use Labetalol, Nifedipine, methyldopa
- Start Aspirin 150mg at 12 weeks (High Risk Pregnancy)
management in labour dot type 1 & 2 diabetes patients?
Maintain good blood glucose during labour IV insulin and IV dextrose
drug treatment for type 1 and 2 diabetes in pregnancy?
T1 Diabetes - Insulin
T2 Diabetes - Metformin, Will probably need Insulin later
GDM – Lifestyle, Metformin and May need Insulin
post partum gestational diabetes control
6 week post natal fasting glucose or GT (glucose tolerance)
- ensure resolution of DM
- of not resolved they have T2DM
what is the risk of type 1 and 2 diabetes if someone has had gestational diabetes
much greater risk of developing type 2 diabetes (50% in 10-15 years)
slightly increased risk of developing type 1 diabetes
what steps should be taken post partum in someone who had gestational diabetes to prevent their development of T2DM?
Keep weight as low as possible Healthy Diet o low refined sugar o predominant starch o low saturated fat o low energy foods Aerobic exercise ?? Metformin, Acarbose, Pioglitazone Annual fasting glucose
