Diabetes in Pregnancy Flashcards
(UNITE) Insulin levels from conception to 12 weeks
low insulin levels
increased estrogen, progesterone
increased pancreatic b cell hyperplasia
increased insulin resistance
(UNITE) insulin requirements 20 weeks to delivery
increase (3x normal)
fetoplacental hormones
decreased maternal insulin sensitivity
(UNITE) t/f universal screening using laboratory tests is recommended
f, it’s not recommended as it would identify very few individuals who are at risk
(UNITE) laboratory testing should be considered in ___
all adults >40 yo
(UNITE) if initial tests are negative for diabetes, repeat testing should be done every ____
year
(UNITE) t/f screening for t1dm among children is not recommended
t, disease is of low prevalence
(UNITE) age when screening for pre-diabetes/t2dm is recommended for children
10 yo or puberty
(UNITE) risk factors for child dm
overweight/obese family history signs of insulin resistance maternal history of dm gdm during child's gestation
(UNITE) criteria for diagnosing dm
fbs >126 mg/dl (7.0 mmol/l) after overnight fast of at least 8-14 hrs
2 hr plasma glucose >200 mg/dl (11.1 mmol/l) in ogtt
rbs >200 mg/dl w/ symptoms of hyperglycemia or hyperglycemic crisis
(UNITE) ogtt is first test for:
previous fbs with impaired fasting glucose (100-125 mg/dl)
previous diagnosis of cvd or high risk for cvd
diagnosis for metabolic syndrome
(UNITE) not recommended for diagnosis of diabetes
urine glucose
plasma insulin
(UNITE) criteria for pre-diabetes
impaired fasting glucose: fbs 5.6 mmol/l (100 mg/dl) to 6.9 mmol/l (125 mg/dl)
impaired glucose tolerance: rbs 7.7-11.0 mmol/l (140-199 mg/dl) or 2 hr bs 7.7-11.0 mmol/dl
(UNITE) normal blood sugar
fbs <5.6 mmol/l (100 mg/dl)
rbs < 7.7 mmol/ (140 mg/dl)
2 hr bs <7.7 mmol/dl (140 mg/dl)
(UNITE) t/f all women should be screened for gdm
true, at first prenatal visit
(UNITE) routine testing for gdm is recommended at (time) ____ for women with no risk factors
24-28 weeks aog
(UNITE) testing for gdm should be carried out in women at risk ____ (time)
even beyond 24-28 weeks aog
(UNITE) ogtt should be done ___ (time) after delivery in gdm women who do not have diabetes immediately postpartum
6-12 weeks after delivery
(UNITE) t/f rbs and fbs is recommended for long term follow up and reclassification of previous gdm
f, not recommended. but if they have fbs/rbs at consult, threshold will be the same as non-pregnant
(UNITE) t/f women with previous gdm should also undergo screening for cv risk factors and components of metabolic syndrome
true
(ADA) starting at ___ and continuing in all women with diabetes and reproductive potential, preconception counselling should be incorporated into routine diabetes care
puberty
(ADA) glucose level recommended to reduce risk of congenital anomalies, preeclampsia, macrosomia, and other complications
A1c < 6.5%
(ADA) glycemic targets for gdm and preexisting diabetes
fbs < 95 mg/dl (5.3 mmol/l)
1 hr ppg <140 mg/dl (7.8 mmol/l)
2 hr ppg <120 mg/dl (6.7 mmol/l)
(ADA) a1c target for pregnancy
ideally <6% but ok <7% to prevent hypogly
(ADA) preferred medication for treating hypergly in gdm, t1dm in preg, and t2dm in preg
insulin
metformin and glyburide cross the placenta to the fetus, not recommended
