Diabetes in Pregnancy

Question 1

how is a glucose tolerance test done

Answer 1

overnight fasting followed by plasma glucose test; 75g glucose drank then another plasma glucose done 2 hours later

Question 2

who should be screened for GTT

Answer 2

previous GDM
BMI >30
previous baby >4.5kg
1st degree diabetic relative
previous stillbirth
high risk ethnicity

Question 3

what ethnicities are considered high risk for GDM

Answer 3

south asian
carribean
middle east

Question 4

what pharmacological options are given for GDM

Answer 4

insulin

metformin

Question 5

what advice is given to GDM women

Answer 5

diet
home glucose monitoring
glycaemic control
BM targets

Question 6

what antenatal care should GDM women receive

Answer 6

additional retinal, renal and hba1c assessments

serial growth scans after 28 weeks

offer induction or c section

Question 7

for diabetic women what additional bloods are done at booking?

Answer 7

U&Es
LFTs
TFTs
HbA1c

Question 8

what is the recommended CTG schedule for diabetic women?

Answer 8

every week after 34 weeks

Question 9

what is VRIII

Answer 9

variable rate intravenous insulin infusion

during labour for diabetic mothers

Question 10

post-natal care for diabetic women

Answer 10

T1DM - continue VRIII and insulin until stable, then go back to previous regime
T2DM - stop VRIII and monitor BM, prescribe treatment PRN
GDM - stop all treatment and review in 2-3 months

Question 11

what neonatal care is important for babies born of diabetic mothers?

Answer 11

BM monitoring and feeding - risk of hypoglycaemia