Gestational diabetes and diabetes in pregnancy Flashcards
What hormone causes implantation of a fertilised egg in the uterus?
HCG (Human Chorionic Gonadotrophin)
What are some hormones produced by the placenta?
- Human placental lactogen
- Placental progesterone
- Placental oestrogen
When does the foetus begin to produce it’s own insulin?
During the 3rd trimester
What is a possible complication of maternal T2DM and gestational diabetes on the baby?
Macrosomia (High birth weight), as the babies own insulin begins to act as a growth factor in the 3rd trimester
How does gestational diabetes occur?
Human placental lactogen and placental progesterones cause an increased insulin resistance in the mother in order to direct more sugars into the foetus
If the mother is predisposed to increased insulin resistance, this may lead to gestational diabetes
How long after birth should gestational diabetes remiss?
6 weeks
How are mothers screened post-nasally for gestational diabetes?
Fasting glucose, HbA1c and GTT
If a suspected gestational diabetes remains in those after 6 weeks post-natal, what condition is present?
T2DM
How should patients with gestational diabetes prevent development into T2DM?
Keep weight as low as possible
Maintain a healthy diet
Perform aerobic exercise
Take annual fasting glucose checks
What is HCG used for in practise?
Pregnancy testing
What is the main function of human placental lactogen?
Stimulates breast development
What are the 2 most important things to do for antenatal care in people with T1/T2 diabetes?
Counselling
Folic acid supplementation
When does gestational diabetes usually occur?
3rd trimester
What is the first line management option for hypertension in pregnancy?
Labetalol
What secretes HCG in fertilisation?
The implanted fertilised ovum
When should folic acid be started in pregnancy?
3 months before conception
What is the risk of T2DM in pregnancy after gestational diabetes?
50% 10 year risk
What are some management options in T1 and T2DM in pregnant women?
Pre-pregnancy counselling
Folic acid 5mg
Change from tablets to insulin
Regular eye checks
Avoid ACEi and statins
Start aspirin 150mg at 12 weeks in high risk
When do eye checks occur in T1 and T2DM in pregnancy?
At 10, 20 and 30 weeks
What are some measurements that require monitoring during pregnancy in cases of diabetes?
- Monitor minimum 4x per day, before meals and before bed
- Monitor HbA1c
- Monitor BP
