Endocrine - Diabetes In Pregnancy

Question 1

Before Pregnancy aim for Hb1AC levels?

Answer 1

Below 48mmol/mol

Question 2

What should diabetic pregnancy pt’s be taking before pregnancy? And why?

Answer 2

Folic acid 5mg until Week 12

Prevent neural tube foetal defects

Question 3

What should you do with antidiabetic meds during pregnancy?

Answer 3

Stop all anti diabetics except metformin

And replace with insulin

Question 4

First line insulin in pregnancy?

Answer 4

Isophane insulin

Question 5

What should occur to insulin doses during different trimesters?

Answer 5

Increase isophane insulin dose in second and third trimester

Question 6

What should happen if pregnant pt takes statins/ACE/ARBS?

Answer 6

Discontinue

Question 7

If fasting BG is less than 7mmol/l, what should pt do?

Answer 7

1) Diet and exercise

2) Metformin

3) insulin (if metformin contraindicated/ not tolerated or ineffective)

Question 8

If fasting BG is greater than 7mmol/l, what should pt do?

Answer 8

Diet and exercise + insulin +/- metformin

Question 9

If fasting BG is less 6-6.9mmol/l, what should pt do?

Answer 9

Insulin +/- Metformin