Gestational Diabete Mellitus

Question 1

Role of insulin

Answer 1

facilitates the uptake of glucose by facilitating movement from the blood into target cells. Stimulates formation and storage of lipids and glycogen

Question 2

Role of glycogen

Answer 2

Glycagon is on the go, glycagen is how its stored. Mobilises energy reserves and promotes glucose synthesis and glycogen breakdown

Question 3

Risks of untreated GDM for the mother

Answer 3

Increased risk of infection, increased risk of type 2 diabetes later in life, preterm labour, hypertension, polyhydramnios, preeclampsia, operative delivery, c-section

Question 4

Risks of intreated GDM fro the foetus

Answer 4

LGA, preterm, increased risk of diabetes later in life, stillbirth, shoulder dystocia, fetal hyperinsulinemia, hypoglycaemia

Question 5

What should the non-fasting oral glucose challenge test (polycose) result be?

Answer 5

<7.8mmol/L = pass
>7.8mmol/L = requires OTT
>11.1mmol/L = referral to specialist for GDM

Question 6

What oral glucose tolerance test result is diagnostic of GDM?

Answer 6

fasting BSL >5.5mmol/L
two hour post prandial BSL >9.0mmol/L

Question 7

Glucose targets on GDM

Answer 7

fasting <5.0mmol/L
1 hour post-prandial <7.4mmol/L
2 hour post-prandial <6.7mmol/L

Question 8

When should GDM women on insulin plan to give birth?

Answer 8

between 38 and 39 weeks due to metformin increasing incidence of stillbirth post-term

Question 9

When should GDM women that is well controlled with normal fetal growth and no cormorbity plan to give birth

Answer 9

40+ weeks

Question 10

GDM BSL targets in labour

Answer 10

Between 3.5 - 6 mmol/L
Consult if >7 mmol/L