Diabetes In Pregnancy Flashcards
What hormonal changes occur during a normal pregnancy?
Estrogen, progesterone, cortisol, etc.
These hormonal changes are crucial for supporting pregnancy and metabolic adaptations.
What are the effects of increased inflammatory cytokines during pregnancy?
Increased TNF-a, IL-6, CRP
These cytokines can influence insulin resistance and overall metabolic health.
What role do adipokines play in pregnancy?
Affect insulin resistance
Leptin and adiponectin are key adipokines that modulate energy balance and metabolism.
What is the metabolic state during the first trimester of pregnancy?
Anabolic state promoting nutrient storage
This state is characterized by increased lipogenesis and reduced fatty acid oxidation.
What changes occur in insulin sensitivity during the second and third trimesters?
Increased insulin resistance
This is due to accelerated starvation of pregnancy and increased hepatic gluconeogenesis.
What happens to insulin sensitivity postpartum?
Rapid return of insulin sensitivity, especially in breastfeeding mothers
This can help in managing blood glucose levels effectively.
How do glycemic patterns differ between normal-weight and obese women during pregnancy?
Higher fasting and postprandial glucose levels in obese women
This can lead to different management strategies for diabetes.
What is the impact of maternal lipid metabolism on fetal growth?
Impacts fetal fat mass
Increased triglycerides, cholesterol, and FFAs during pregnancy affect fetal development.
What are the strategies to avoid hypoglycemia in type 1 diabetes during the first trimester?
Bedtime snacks, insulin adjustments
These strategies are important to maintain stable blood glucose levels.
What are the risks associated with poor glycemic control during pregnancy?
Congenital anomalies, miscarriage, stillbirth
Maintaining normal glucose control is essential for fetal health.
What is the recommended preconception HbA1C goal?
<6.5%
This target is associated with lower risks for congenital anomalies.
What are the potential long-term risks for offspring of mothers with diabetes?
Psychiatric and neurodevelopmental disorders
This highlights the importance of managing diabetes effectively during pregnancy.
What is the relationship between HbA1C levels and congenital anomalies?
Linear relationship
Higher HbA1C levels increase the risk of congenital anomalies.
What is the first-line therapy for diabetes in pregnancy?
Insulin
Limited data exists on the safety of oral hypoglycemic agents.
What should be done with ACE inhibitors and ATIIR blockers before pregnancy?
Discontinue due to fetal risks
Alternative antihypertensive agents are recommended.
What is the risk associated with coronary artery disease in pregnant women with diabetes?
Increased risk
Functional cardiac testing is recommended before conception.
What is the importance of screening for thyroid disease in pregnant women with diabetes?
Higher risk for thyroid dysfunction
Screening and treatment of hypothyroidism is recommended to prevent complications.
What should be done with statins and fibrates during pregnancy?
Discontinue unless severe hypertriglyceridemia
Pravastatin shows promise for preeclampsia prevention.
How does smoking affect pregnancy outcomes?
Increases risks of low birth weight, preterm birth, and perinatal mortality
Smoking cessation counseling is crucial for expectant mothers.
What is the effect of diabetic nephropathy on pregnancy?
Pregnancy does not accelerate decline in kidney function in mild cases
Severe renal insufficiency increases risks of adverse outcomes.
What is the recommended therapy for women with diabetic nephropathy at high risk for preeclampsia?
Low-dose aspirin and antihypertensive therapy
These treatments can help manage risks effectively.
What is the impact of diabetes on retinopathy during pregnancy?
Pregnancy may worsen retinopathy
Ophthalmologic examination is recommended in the first trimester.
What is the White Classification of Diabetes in Pregnancy?
Classification based on diabetes duration, complications, and treatment
Used to assess maternal and fetal risks.
What are the ADA and ACOG glycemic targets in pregnancy?
Fasting <95 mg/dL, 1-hour postprandial <140 mg/dL, 2-hour <120 mg/dL
These targets are essential for managing diabetes during pregnancy.
