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Reproduction > Gestational Diabetes > Flashcards

Gestational Diabetes Flashcards

1
Q

What is gestational diabetes?

A

State of insulin resistance induced by the metabolic strain of pregnancy

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2
Q

What happens to the abnormal glucose tolerance after pregnancy?

A

It reverts back to normal after delivery

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3
Q

What are people who develop gestational diabetes more at risk of?

A

developing type 2 diabetes later in life

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4
Q

What is the main risk factor for gestational diabetes?

A

Family origin with a high prevalence of diabetes: South Asian, black Caribbean, Middle Eastern

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5
Q

What are other risk factors of gestational diabetes?

A

BMI of > 30 kg/m²
Previous macrosomic baby weighing 4.5 kg or above
Previous gestational diabetes
First-degree relative with diabetes

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6
Q

What is the main investigation of gestational diabetes?

A

Oral Glucose Tolerance Test

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7
Q

When is an oral glucose tolerance test carried out?

A

24-28 weeks

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8
Q

How does gestational diabetes normally present?

A

Asymptomatically

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9
Q

How is gestational diabetes prevented?

A

Regular exercise throughout pregnancy

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10
Q

What is the fasting glucose diagnostic threshold?

A

More than 5.6mmol/l

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11
Q

What is the 2 hour glucose diagnostic threshold?

A

More than 7.8mmol/l

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12
Q

What are maternal complications of gestational diabetes?

A

Increased risk of vaginal tears
Increased risk of type 2 diabetes later in life
Increased risk of cardiovascular disease

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13
Q

What are fetal complications of gestational diabetes?

A

Fetal macrosomia
Hypoglycaemic baby
Shoulder dystocia
Obesity

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14
Q

What are pregnancy complications of gestational diabetes?

A

Increased risk of miscarriage and still birth

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15
Q

What is the initial management of gestational diabetes?

A

Diet and exercise

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16
Q

When would you give metformin?

A

When diet and exercise can’t maintain fasting glucose to less than 7mmol/l

17
Q

How long is diet and exercise trialled before adding metformin?

A

1-2 weeks

18
Q

What is added in the management of gestational diabetes if glucose targets still not met?

A

Short acting insulin

19
Q

In what cases should insulin be given immediately?

A

When fasting glucose is more than 7mmol/l at the time of diagnosis
If fasting glucose is between 6-6.9mmol/l and there are complications

20
Q

What would you do if fasting glucose was more than 7mmol/l at the time of diagnosis?

A

Give short acting insulin immediately

21
Q

What are possible complications which would indicate giving short acting insulin with a fasting glucose between 6-6.9mmol/l?

A

Macrosomia
Polyhydramnios

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