Gestational Diabetes Flashcards
What is Gestational Diabetes?
Diabetes triggered by pregnancy
What percentage of Pregnant women will have GD?
20%
What is GD caused by?
Progressively reduced insulin sensitivity @ pregnancy
Does GD resolve @ birth?
Yes
What are the RF for GD? (6 things)
- Previous GD
- Previous Macroscomic baby (4.5kg +)
- BMI 30+
- Caribbean / Middle Eastern / South Asian
- FHx of DM
- PCOS
If a pregnant woman has RF for GD, what should happen?
Oral Glucose Tolerance Test (OGTT) @ 24-28 weeks
If a pregnant woman has previously had GD, what should happen?
OGTT after Booking Clinic
What CF could suggest GD? (3 things)
- Large for GA
- Polyhydramnios
- Glucose on Urine dipstick
What are the CF of GD? (4 things)
- Asymptomatic (most woman w pancreatic reserve)
- Polyuria
- Polydipsia
- Fatigue
What is the NICE recommendation for a GD woman with Fasting glucose less than 7? (3 things) (IN ORDER)
- Diet + Exercise Trial for 1-2 wks
- Metformin
- Insulin
What is the NICE recommendation for a GD woman with Fasting glucose of 7+? (2 things) (IN ORDER)
- Insulin
- Metformin
What is the NICE recommendation for a GD woman with Fasting glucose of 6+ + Macrosomia / Other complications? (2 things) (IN ORDER)
- Insulin
- Metformin
What can you give women who decline Insulin / Can’t tolerate Metformin?
Glibenclamide (a Sulfonylurea)
What monitoring scans do GD women need during pregnancy?
US scans every 4 weeks (from 28-36 weeks)
What is monitored in the US scans every 4 weeks for a GD woman? (2 things)
- Foetal growth
- Amniotic fluid volume
When should a woman aim to deliver if her GD is managed by Treatment?
37-38 weeks
When should a woman aim to deliver if her GD is managed by Diet?
B4 40+6 weeks
What type of delivery should a woman w GD managed by Diet be advised to have? (2 things)
- Induction of labour
- C section
When can a GD woman stop her GD medication?
Immediately after birth
What should be checked before a GD woman is discharged?
Blood glucose
(to check it has returned to normal levels)
What are GD women at risk of developing in future?
DM
What percentage of GD women will develop T2DM in future?
50%
What should you do to monitor risk of developing DM in GD women?
Fasting glucose test 6-13 weeks after giving birth
If the Fasting glucose test 6-13 weeks after giving birth is normal, what should you do?
Offer yearly tests
(bc still risk of developing DM in future)
What are babies of GD woman at risk of? (6 things)
- Macrosomia
- Neonatal hypoglycaemia
- Polycythaemia
- Jaundice
- Congenital HD
- Cardiomyopathy
How do you manage the risk of a baby of a GD woman developing Neonatal hypoglycaemia? (2 things)
- Regular blood glucose checks
- Frequent feeds
What should you give if the baby’s Blood Glucose drops below 2?
IV dextrose (via NG tube)
