Gestational Diabetes

Question 1

Risk factors for gestational diabetes

Answer 1

BMI of > 30 kg/m²

previous macrosomic baby weighing 4.5 kg or above

previous gestational diabetes

first-degree relative with diabetes

family origin with a high prevalence of diabetes (South Asian, black Caribbean and Middle Eastern)

Question 2

thresholds for gestational diabetes

Answer 2

fasting glucose is >= 5.6 mmol/L
2-hour glucose is >= 7.8 mmol/L

Question 3

Mx of gestational diabetes

Answer 3

fasting plasma glucose level is < 7 mmol/l a trial of diet and exercise should be offered

glucose targets are not met within 1-2 weeks of altering diet/exercise metformin should be started

if glucose targets are still not met insulin should be added to diet/exercise/metformin

Question 4

What type of insulin is offered

Answer 4

gestational diabetes is treated with short-acting, not long-acting, insulin

Question 5

fasting glucose level is >= 7 mmol/l

Answer 5

insulin should be started

Question 6

women who cannot tolerate metformin or those who fail to meet the glucose targets with metformin but decline insulin treatment

Answer 6

glibenclamide