Diabetes in Pregnancy Flashcards
What is gestational diabetes?
carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or first recognition during pregnancy
When does gestational diabetes resolve?
when pregnancy ends
For type 1 and 2 diabetes, how should pregnancy be managed?
avoid pregnancy if above 86mmol/mol
stop ACEi and cholesterol lowering agents
5mg folic acid 3 months before conception -> week 12 of conception
growth scan 4weekly from 28 weeks
When should T1DM and T2DM mothers deliver their babies?
38 weeks
What are risk factors for gestational diabetes?
previous GDM BMI >30 1st degree relative FH glycosuria ethnicity - South Asia, black carribean, middle eastern previous big baby polyhydramnios big baby on USS
What is the pathophysiology behind gestational diabetes?
HPL and cortisol are diabetogenic hormones which cause overgrowth of insulin sensitive tissues and macrosomnnia, hypoxic state in utero, foetal metabolic reprogramming leading to long term risk of obesity, insulin resistane and diabetes
What are the fasting and 2 hour BG diagnostic values for gestational diabetes?
fasting >5.1
2 hour > 8.5
When should OGTT be performed in pregnancy?
1st trimester and 24-28weeks
What are the fasting and 2 hour glucose targets?
fasting = 3.5-5.5
2 hour = <7.8
When should a woman with gestational diabetes on insulin give birth?
38-39 weeks
When should a woman with gestational diabetes on metformin give birth?
39-40 weeks
When should a woman with gestational diabetes on diet alone give birth?
40-41 weeks
What should be done if the estimated foetal weight >4.5kg?
c/section
What follow up should be done for those with gestational diabetes?
fasting blood sugar in 6-8 weeks
