Diabetes in Pregnancy

Question 1

Gestational diabetes develops during pregnancy and goes away immediately post birth. Why is it though to occur?

Answer 1

h-PL reduces insulin sensitivity

Question 2

In what trimester is gestational diabetes normally diagnosed?

Answer 2

3rd

if diagnosed before this likely to have been diabetic beforehand

Question 3

Oral glucose tolerance test is used to test for gestational diabetes. SIGN guidelines are used for the parameters. What are the fasting and 2 hour levels which indicate the condition?

How much glucose drink is req.?

Answer 3

Fasting =/5.1 mmol/l
2hr =/>8.5mmol/l

75g glucose drink

Question 4

What impact diabetes during pregnancy have on the baby?

What complications can happen during/post labour?

Answer 4

Macrosomia

Shoulder dystocia

Neonatal hypoglycaemia - baby is used to high levels of glucose and can suffer hypo post birth <2mmol/l

Question 5

What must be screened for in diabetic mothers?

• common exam/OSCE question -

Answer 5

Diabetic retinopathy - refer to optometrist

Diabetic nephropathy

Question 6

What level on HBA1C would you discourage pregnancy?

Answer 6

> 86 mmol/mol

Question 7

What amount of folic acid should diabetics get?

Answer 7

5mg - high dose

Question 8

What drug treatment is used in gestational diabetes?

Answer 8

Oral or insulin they have a choice

Question 9

How many times a day will a mother have to test blood sugar

Answer 9

min 4 a day

Pre-breakfast
2x after meals (1-2hrs post)
Pre-bed