Diabetes In Pregnancy Flashcards
Which medications are contraindicated in pregnancy?
Statins, ACE inhibitors, ARBs, and most non insulin therapies
How does pregnancy affect the management of DM?
Placental hormones, growth factors, and cytokines cause a progressive increase in insulin resistance
What are optimal glycemic goals throughout pregnancy? (ADA)
Pre-meal, bedtime, and overnight: <95 mg/dL
Peak postprandial:
<140–1 hour
<120–2 hours
A1c: 6.0-6.5%
When should urine ketone measurements be taken in pregnancy
At times of illness or when BG reaches 200 mg/dL. Positive values should be reported to a health professional.
What is the RDA for CHO in pregnancy?
175 g per day
What are folate recommendations during pregnancy?
Child bearing age: 400 ug
During periconception and prenatal periods: 600 ug
^^to be obtained from diet, supplements, or both
What is the initial daily dose of insulin when converting woman with DM2 to insulin therapy in pregnancy?
0.7-1.0 units/kg actual BW
Of the insulin analogs, which are shown to be safe and effective during pregnancy?
Aspart and lispro
What is the dawn phenomenon?
Increased insulin requirements between 4 and 8 am
In someone using an insulin pump, what might cause DKA?
Insulin delivery failure (due to kinking of catheter or other infusion site issues)
True or false: oral meds for treatment of DM2 should be stopped and insulin starter/titrated to achieve acceptable glucose control before conception?
True
Why is oral agent use in pregnant woman controversial?
Concern for transplacental passage during fetal development and increased risk of insulin resistance of pregnancy
What are recommendations for exercise and pregnancy?
At lease 30 mins/day—monitor CBG around times of exercise
What is GDM?
Diagnosed in 2nd or 3rd trimester—not overt DM before gestation
What oral DM med may be used in pregnancy?
Metformin
