Diabetes in Pregnancy Flashcards
what are the two phases of mensuration
follicular
luteal
What triggers ovulation
A surge in the production of LH
What does FSH do in the follicular phase
stimulated development and maturation of the follicle
stimulates oestrogen release from the ovarian tissues
what happens to the follicle in the luteal phase
it becomes the corpus luteum
what stimulates HCG release
Implantation of the corpus luteum
why are oestrogen and progesterone levels high in the luteal phase
secreted by the corpus luteum and act as negative feedback on the pituitary gland so no more follicles are developed at this time
what hormones does the placenta produce
Human placental lactogen
Placental progesterone
Placental oestrogen
what does prolactin do
stimulates further development of breast tissue to allow breast feeding an lactation??
released by the pituitary in the luteal phase
what can cause insulin resistance in pregnancy
The release of progesterone
The release of hPL from the placenta
what are the 3 types of diabetes seen in pregnancy
Type 1
Type 2
Gestational
when does gestational diabetes most commonly develop
within the last trimester as that’s when the hormones really start to increase in quantity
when does foetal organogenesis start
5 weeks or possibly earlier
how can high blood glucose levels cause congenital malformations
by disrupting foetal organogenesis
What are some complications that occur due to diabetes in pregnancy
congenital malformations prematurity Into-uterine growth retardation macrosomia Polyhydramnios Intrauterine death
what are some complications in the neonate due to diabetes
respiratory distress (more immature lungs) Hypoglycaemia Risk of CNS defects Skeletal abnormalities Genital and GI abnormalities
How do you manage type 1 and 2 diabetes in pregnancy
pre-pregnancy counselling Folic acid (5mg) Consider change from T2DM to insulin before pregnancy regular eye checks acoid ace inhibitors and statins control lifestyle control BG monitor HbA1c Monitor BP
how can you maintain good blood glucose control during labour
IV insulin
IV dextrose
When should gestational diabetes go away after pregnancy
5-12 weeks
If it doesn’t go away then the patients has T2DM
how does gestational diabetes increase your risk of getting T2DM
gestational diabetes is a marker of having insulin resistance meaning the patients is more likely to go on to develop T2DM
(50% will go on to develop T2DM)
How to prevent T2DM after gestational diabetes
Keep weight low as possible Healthy diet Aerobic exercise Metformin Annual fasting glucose
