Gestational Diabetes Flashcards
Gestational Diabetes is define as as condition of abnormal glucose metabolism that arises when?
During pregnancy
GDM is defined as hyperglycemia with first onset when?
During pregnancy
What are the risk factors for a woman developing GDM? (6)
- age >25 years
- Family Hx Diabetes
- Race (asian, hispanic, native)
- obestiy
- History of large babies >10 pounds
- Patient medical history (PMHX)
What could this PMHX include? (3)
- Congentinal anomalies (aka birth defects) in pregnancy
- Polycystic ovary syndrome
- Unexplained fetal loss
How can you prevent GDM from occuring?
- healthy diet
- Lose extra weight prior to becoming pregnant
- maternal supplements and vitamins
- Regular check ups and screening for GLT, proteinuria, HTN
- Glycemic control for diabetic mothers (type 1 and type 2)
How soon should a mother begin taking maternal supplments before conception?
3 months prior
What does the diagnosis of GDM include:
- When is it tested?
- What is it testing for?
- 24-28 weeks during gestation for ALL pregnant women
2. Gestational Diabetes Screen (GGT) 50 g of glucose load followed by plasma glucose test measured 1 hour later
The recommonded glycemic targets are diffrerent for a pregnant woman than a non pregnant woman. What are they for.. 1. Fasting glucose? 2. 1 Hr postprandial PG? 3. 2 Hr postprandial PG? 4. AIC?
- 3.8-5.2
- 5.5-7.7
- 5-6.6
4.
The four interventions that can be done for GDM include
- Self monitering of blood glucose
- Presnse of ketones in blood / urine
- Nutrition therapy (dietician)
- Physical Activity
Explain the role each of these play.
- This is esesential. If patient is on insulin, increased risk of nocturnal hypoglycemia
- Monitors dietary intake is adequate
- Proper weight gain, nutrition and meal planning (adequate protein and calcium)
- encouraged unless restricted to bedrest
What are the complications that occur for mom with GDM? (4)
- Retinal problems
- Renal problems
- Cardiovascular problems
- HTN (can lead to pre-eclampsia)
What are the complications that can occur for the baby when the mother has GDM:
- During conception and first triemester:
- Later in pregnangy
- increased risk of fetal malformations
2. Increased risk of marcosomia and metabolic complications at birth
Explain Marcosomia…
Mothers blood brings extra glucose to the fetus, fetus then makes extra insulin to handle it, extra glucose gets stored as fat and fetus becomes larger than normal.
From after birth until 18 hours..baby is at high risk for what?
What are the nursing interventions that are done to try to avoid this?
Hypoglycemia
Keep feeding baby and warm within 18 hours is critical
During the pregnancy.. if a woman has GDM and is not able to return to normal glucose levels within 2 weeks of altering the diet, what is prescribed?
- What type of insulin?
- Using what type of scale?
- What are you continuously monitoring for?
- You also assess fetal growth using what device?
- Humalog (rapid acting)
- Sliding scale
- Hypo/hyperglycemia
- Ultrasound
Diabetes type 1 in children and adolescnets:
this is the most common what type of disorder? (2)
Endocrine and chronic disease
