Gestational Diabetes Flashcards
What is gestational diabetes?
State of insulin resistance induced by the metabolic strain of pregnancy
What happens to the abnormal glucose tolerance after pregnancy?
It reverts back to normal after delivery
What are people who develop gestational diabetes more at risk of?
developing type 2 diabetes later in life
What is the main risk factor for gestational diabetes?
Family origin with a high prevalence of diabetes: South Asian, black Caribbean, Middle Eastern
What are other risk factors of gestational diabetes?
BMI of > 30 kg/m²
Previous macrosomic baby weighing 4.5 kg or above
Previous gestational diabetes
First-degree relative with diabetes
What is the main investigation of gestational diabetes?
Oral Glucose Tolerance Test
When is an oral glucose tolerance test carried out?
24-28 weeks
How does gestational diabetes normally present?
Asymptomatically
How is gestational diabetes prevented?
Regular exercise throughout pregnancy
What is the fasting glucose diagnostic threshold?
More than 5.6mmol/l
What is the 2 hour glucose diagnostic threshold?
More than 7.8mmol/l
What are maternal complications of gestational diabetes?
Increased risk of vaginal tears
Increased risk of type 2 diabetes later in life
Increased risk of cardiovascular disease
What are fetal complications of gestational diabetes?
Fetal macrosomia
Hypoglycaemic baby
Shoulder dystocia
Obesity
What are pregnancy complications of gestational diabetes?
Increased risk of miscarriage and still birth
What is the initial management of gestational diabetes?
Diet and exercise
When would you give metformin?
When diet and exercise can’t maintain fasting glucose to less than 7mmol/l
How long is diet and exercise trialled before adding metformin?
1-2 weeks
What is added in the management of gestational diabetes if glucose targets still not met?
Short acting insulin
In what cases should insulin be given immediately?
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
What would you do if fasting glucose was more than 7mmol/l at the time of diagnosis?
Give short acting insulin immediately
What are possible complications which would indicate giving short acting insulin with a fasting glucose between 6-6.9mmol/l?
Macrosomia
Polyhydramnios
