Diabetes in pregnancy management Flashcards
What are the diagnostic parameters for gestational diabetes?
Fasting >/= 5.6
and/or
2 hour post prandial >/=7.8
When should neonatal blood sugars be tested?
Within 2-4 hours
What level of blood glucose is considered neonatal hypoglycaemia?
<2mmol/L
What sugar levels should you aim for in pregnancy?
4-7
When should retinal screening be performed?
Within 6 months pre-pregnancy
At booking if not performed within last 3 months
(If diabetic retinopathy repeat at 16-20 weeks)
Repeat at 28 weeks
When should retinal screening be repeated if there is existing diabetic retinopathy?
16-20 weeks at 28 weeks
What is the target pre-pregnancy Hba1c?
<48, <6.5%
What Hba1c level would pregnancy be contraindicated?
> 86 , >10%
When should a patient be referred to a nephrologist pre-pregnancy?
creatinine >120
eGFR <45
Albumin:creatinine ratio <30
When should a patient be referred to a nephrologist in pregnancy?
creatinine >120
albumin: creatinine ratio >30
Protein excretion >0.5g/day
What is the target fasting blood sugar in pregnancy?
5.3
What is target blood sugar 1 hour post prandial in pregnancy?
7.8
What is target blood sugar 2 hours post prandial in pregnancy?
6.4
In GDM, what fasting level would indicate a trial of diet control?
<7
In GDM, what fasting level would indicate treatment with metformin/insulin?
> 7 or 6-6.9 + macrosomia/polyhydramnios
