Diabetes in Pregnancy Flashcards
gestational diabetes
pre-existing diabetes or developing diabetes during pregnancy
risk factors
BMI>30
first relative history of diabetes
previous gestation diabetes
previous macrosomic baby
what is the best investigation used
OGTT
what types of OGTT will you do
fasting glucose
normal plasma glucose
when would you want to do OGTT
if the patient has one of the risk factors
what values will diagnose gestational diabetes from the OGTT
fasting >/= 5.6
plasma glucose >/= 7.8
when do you do an OGTT
previous gestational diabetes:
first screening
24-28 weeks
other risk factor present:
24-28 weeks
management
fasting glucose < 7
1st line - exercise and diet
2nd line - metformin
3rd line - insulin
fasting glucose > 7
insulin
plasma glucose between 6-6.9 + risk of macrosomia
insulin
management of pre-existing diabetes
good diet and exercise
metformin
high dose folic acid pre-conception to 12 weeks gestation
what type of insulin is used
short-acting
what are the complications for the foetus and mother
foetus:
macrosomia
hypoglycaemic
pre-term delivery
mother:
pre-eclampsia
type 2 diabetes later on in life
another gestation pregnancy
