Gestational Diabetes - د.حيدر

Question 1

what is the Gestational diabetes ?

Answer 1

its the diabetes that onset and presented during pregnancy

Question 2

how much pregnent lady are susptiple to Gestational diabetes ?

Answer 2

only 17% of pregnant women

Question 3

if the pregnent women had Gestational diabetes dose is presist ?

Answer 3

no , about 88% having diabetes during pregnancy then dissapear but 12% of them will have persistant diabetes

Question 4

why the Gestational diabetes happen ?

Answer 4

normally the pregnant women will have insulin resistance during pregnancy because of the hormone that antognizing the work of the insulin
but when the pancrese cant produce suffiecnt amount of insulin to compensate the resistance

Question 5

which group are risky for the Gestational diabetes ?

Answer 5

1- overwight body mas index over 25 kg /cm2
2- ager over 25 
3- family history  of type2 
4- ethincity (Arab)
5- Previous glucose abnormality 
6- Previous macrosomic more than 4kg
7-Previous unexplained stillbirth 
8-polyhydramnios

Question 6

what the risk of the diabetes during the pregnecy ?

Answer 6

its have risks on the mother during the pregnency and on the labor and later in life
and have risk on the baby

Question 7

what are the possible risks of the Gestational diabetes during the pregnancy ?

Answer 7

1- increase the risk of the DKA 
2- retionpathy , worsening for the kidney , heart and the nerve 
2- increase the hypoglycemia 
3- hypertension 
4- polyhydraminios 
5- preterm labor

Question 8

what are the possible risks of the Gestational diabetes on the labor ?

Answer 8

1- shoulder dystocia (the baby’s anterior shoulder gets caught above the mother’s pubic bone)

2- operative vaginal delivery
3- 3rd & 4th degree of perineal tear
4- cs
5-postpartum heamorrge

Question 9

what are the possible risks of the Gestational diabetes later in life ?

Answer 9

they will suffer from type 2 diabetes

Question 10

what are the possible risks of the Gestational diabetes on the fetus ?

Answer 10

1- causing death :

• stillbirth(the birth of an infant that has died in the womb survived through at least the first 28 weeks of pregnancy)
• miscarriage (Miscarriage is when an embryo or fetus dies before the 20th week of pregnancy.)
• perinatal death (period immediately before and after birth)

2- cause fetal maldevelopment :

• congintal abnormality
• macrosomia

3- cause birth trauma:

• shoulder dystocia
• bone fracture
• bracjail plexus palsy
• hyperbillirubeniemia (jaundaice)
• neonatal hypoglycemia

Question 11

Does all women need screening for DM ?

Answer 11

yes , it perform at the 2nd half (24-28 week )of the pregnancy for any pregnent lady

by performing OGTT (oral glucose torlance test)
pt should be fasting at least 8h then give him 75g of glucose
then measure the fasting after 1 and 2 h

Question 12

whatre the numbers of the Gestational diabetes that confirm DM ?

Answer 12

fasting is more 92 mg/dl
1h is more 180 mg/dl
2h is more 153 mg/dl

Question 13

if you have pregnant lady with GDM how can U manage ?

Answer 13

1- first we should try the diet modification by consuming the complex CHO instead of the refined sugar

2- if the diet didnt work so use the metformin and glibnclemide
3- insulin may be required

Question 14

when pt with GDM how to control ?

Answer 14

she should control when diet modification
the preparndial target is 95
postprandial 1h is 160
2h target is 140

Question 15

Can we stop fallow up of the pt with GDM?

Answer 15

no , we should continue screenig espacially for the overwight pt and do screening annually for type2
because some of them develop DM by 10 years

so after 3-6 month of delivery OGTT should be done