Gestational diabetes

Question 1

Pregnancy causes

Answer 1

hyperinsulinemia and insulin resistance

high insulin allows glucose homeostasis

Question 2

GDM occurs when

Answer 2

insulin is deficient to the point it can’t counteract pregnancy induced insulin resistance

Question 3

RF for GDM are

Answer 3

obesity 
FHx of diabetes 
25+ y/o 
glucosuria 
Hx of GDM 
Hx of macrosomia (>8.13 lbs)

Question 4

How do you diagnose GDM

Answer 4

Give 50g glucose, measure BG in 1 hr. If >120…

Give 100g glucose, measure BG at fasting, 1, 2, 3 hrs. If 2+ reads are >130, patient has GDM

Question 5

What is the #1 medical complication in pregnancy

Answer 5

Gestational DM

Question 6

Complications of GDM include

Answer 6

Macrosomia 
placental abrution 
congenital abnormalities 
premature birth 
fetal demise 
delayed lung function 
pre-eclampsia 
Pregnancy induced HTN

Question 7

How do you manage GDM

Answer 7

Monitor capillary blood glucose levels (fasting, and 2 hrs after each meal); INSULIN!!
ADA diet (diet alone can fix your problem!)
Moderate exercise
Nutrition consult
Fetal monitoring with non-stress test and BPP (US)

Question 8

What are goal glucose levels in GDM

Answer 8

Fasting: <95-105
postprandial: <120

Question 9

What must you do in a postpartum woman with GDM

Answer 9

2 hour OGTT 6 weeks postpartum to ensure it is not T2DM