Gestational Diabetes Flashcards
ethnicities at risk of gestational diabetes?
South Asian, black Caribbean and Middle Eastern
risk factors for gestational diabetes?
-5
- BMI > 30 kg/m²
- previous macrosomic baby weighing 4.5 kg or above
- previous gestational diabetes
- first-degree relative with diabetes
- South Asian, black Caribbean and Middle Eastern
how to screen gestational diabetes for women who’ve previously had gestational diabetes?
oral glucose tolerance test (OGTT) should be performed ASAP & at 24-28 weeks if the first test is normal.
how to screen gestational diabetes for women with any risk factors?
OGTT at 24-28 weeks
symptoms?
-3
Polyuria
Polydipsia
Tired
what glucose values do you need to diagnose gestational diabetes?
-2
- fasting glucose is > 5.6 mmol/L
* 2-hour glucose is > 7.8 mmol/L
glucose targets for pregnant lady self-monitoring?
Fasting < 5.3 mmol/l
2-hour glucose is < 6.4 mmol/L
pregnant women newly diagnosed with gestational diabetes.
initial non-medicative/lifestyle type Mx?
Diet (foods with low GI, low-fat dairy, high fibre) + exercise
pregnant women newly diagnosed with gestational diabetes.
1st line Mx?
2nd line Mx?
diet + exercise
2nd line = start metformin
pregnant women newly diagnosed with gestational diabetes.
on metformin but glucose still high.
what is 3rd line Mx now?
3rd line = start short acting insulin as well
If pre-existing diabetic becomes pregnant,
what is 1st line Mx now?
4 things
1st line = start diet + exercise + metformin + insulin all together
Problems a diabetic mum poses to baby?
i. e. what risk are there to baby now
- 6
high birth weight macrosomia miscarriage neonatal hypoglycaemia obesity later in life for the child still birth.
Pathophysiology of gestational diabetes?
- step by step
Placenta making glucagon, cortisol, human placental lactogen > ↑mum’s glucose > mum makes ↑insulin to counteract > maternal cells become insulin insensitive > mum hyperglycaemic
why does placenta making glucagon, cortisol, human placental?
so baby has glucose supply to grow
