Dm Flashcards
What is Gestational Diabetes Mellitus (GDM)?
A form of diabetes that occurs during pregnancy.
When should screening for GDM be conducted?
Between 24-28 weeks of gestation.
What are the two approaches for GDM screening?
One-Step or Two-Step method.
What is the One-Step approach for GDM screening?
75-g OGTT with diagnostic criteria based on one abnormal value.
What are the diagnostic criteria for the One-Step approach?
Fasting: >92 mg/dL, 1-hour: >180 mg/dL, 2-hour: >153 mg/dL.
What is the first step in the Two-Step approach for GDM screening?
Perform a 50-g Glucose Load Test (GLT) (non-fasting).
What indicates proceeding to step 2 in the Two-Step approach?
If glucose level is >130 mg/dL.
What is the second step in the Two-Step approach?
Perform a 100-g OGTT.
What are the diagnostic criteria for the Two-Step approach?
Diagnosis requires two or more abnormal values: Fasting: >95 mg/dL, 1-hour: >180 mg/dL, 2-hour: >155 mg/dL, 3-hour: >140 mg/dL.
What is the first-line management for GDM?
Lifestyle modifications (diet and exercise).
What should be done if glucose levels remain uncontrolled in GDM?
Start insulin therapy.
Metformin and glyburide are alternative options.
What are the target fasting glucose levels during treatment for GDM?
90-95 mg/dL.
What is the target 1-hour postprandial glucose level during treatment for GDM?
<140 mg/dL.
What is the target 2-hour postprandial glucose level during treatment for GDM?
<120 mg/dL.
When should early screening for GDM be considered?
In high-risk patients using a glucose challenge test.
What are some risk factors for GDM?
BMI in the overweight or obese range, history of GDM in a previous pregnancy, previous macrosomic baby, family history of diabetes (first-degree relative), PCOS, advanced maternal age (≥40 years).
What screening should patients with GDM have at their postpartum visit?
A 75-g OGTT to check for persistent diabetes.
What should be done if postpartum results are normal for GDM patients?
Repeat screening every 3 years to monitor long-term risk of type 2 diabetes.
What is a BMI indication for Metformin in prediabetes?
BMI > 35 kg/m²
What age is considered for Metformin indication in prediabetes?
Age < 60 years
What history is considered for Metformin indication in prediabetes?
History of Gestational Diabetes Mellitus (GDM)
What fasting glucose level indicates Metformin use in prediabetes?
Fasting glucose nearing diabetic levels (>110)
What is the HbA1c range that indicates Metformin use in prediabetes?
HbA1c between 5.7%-6.4%, especially closer to 6.4%.
When should Metformin be considered if lifestyle modification fails?
After 3-6 months of lifestyle modification.
What does the ‘5C Approach’ in chronic disease follow-up refer to?
The 5C Approach includes: Complain, Control, Compliance, Comorbidity, Complication.
What does ‘Complain’ refer to in the 5C Approach?
It refers to the patient’s current symptoms or issues.
What does ‘Control’ refer to in the 5C Approach?
It refers to the management and regulation of the chronic disease.
What does ‘Compliance’ refer to in the 5C Approach?
It refers to the patient’s adherence to the prescribed treatment plan.
What does ‘Comorbidity’ refer to in the 5C Approach?
It refers to the presence of additional diseases or conditions alongside the primary chronic disease.
What does ‘Complication’ refer to in the 5C Approach?
It refers to any additional problems that arise as a result of the chronic disease.
