Gestational Diabetes GDM Flashcards
What is gestational diabetes (GDM)?
gestational diabetes is glucose intolerance first identified during pregnancy, typically resolving after delivery.
What causes gestational diabetes?
It is caused by insulin resistance due to placental hormones like human placental lactogen, progesterone, and cortisol.
When is gestational diabetes typically diagnosed?
gestational diabetes is usually diagnosed between 24-28 weeks of gestation during routine screening.
What are the risk factors for gestational diabetes?
Risk factors include obesity, advanced maternal age, family history of diabetes, previous gestational diabetes, polycystic ovary syndrome (PCOS), and multiple pregnancy.
What are the common symptoms of gestational diabetes?
Most women are asymptomatic, but some may experience excessive thirst, frequent urination, or fatigue.
How is gestational diabetes screened for in the UK?
Women with risk factors undergo an oral glucose tolerance test (OGTT) at 24-28 weeks.
What is the oral glucose tolerance test (OGTT)?
The OGTT measures fasting blood glucose and blood glucose 2 hours after a 75g glucose drink.
What are the diagnostic criteria for gestational diabetes in the UK?
Fasting glucose ≥5.6 mmol/L or 2-hour glucose ≥7.8 mmol/L after the OGTT confirms gestational diabetes.
What are the complications of gestational diabetes for the mother?
Complications include increased risk of pre-eclampsia, caesarean delivery, and developing type 2 diabetes later in life.
What are the complications of gestational diabetes for the fetus?
Complications include macrosomia, shoulder dystocia, neonatal hypoglycaemia, jaundice, and increased risk of obesity and diabetes later in life.
How is gestational diabetes managed initially?
Initial management includes dietary modifications, regular exercise, and blood glucose monitoring.
What is the target blood glucose level for women with gestational diabetes?
Targets include fasting glucose <5.3 mmol/L and 1-hour post-meal glucose <7.8 mmol/L.
When are medications indicated for gestational diabetes?
Medications like metformin or insulin are indicated if blood glucose targets are not met with diet and exercise alone.
What is the role of metformin in gestational diabetes?
Metformin improves insulin sensitivity and is commonly used when diet and exercise fail to control blood glucose levels.
When is insulin therapy required in gestational diabetes?
Insulin is required if blood glucose levels remain uncontrolled despite lifestyle changes and metformin.
What is the role of fetal monitoring in gestational diabetes?
Fetal monitoring includes growth scans to detect macrosomia and amniotic fluid assessment to check for polyhydramnios.
How is labour managed in women with gestational diabetes?
Labour is managed with careful glucose monitoring, and early delivery may be considered for poorly controlled gestational diabetes or fetal complications.
What are the postpartum risks for women with gestational diabetes?
Postpartum risks include persistent hyperglycaemia, recurrence of gestational diabetes in future pregnancies, and increased risk of type 2 diabetes.
How is gestational diabetes monitored postpartum?
Women undergo a fasting glucose test or HbA1c test 6-13 weeks postpartum to check for persistent diabetes or prediabetes.
How can the risk of gestational diabetes recurrence be reduced?
Risk reduction includes maintaining a healthy weight, balanced diet, regular exercise, and early screening in future pregnancies.
What lifestyle advice is given to women with gestational diabetes?
Advice includes eating a balanced diet with low glycaemic index (GI) foods, regular physical activity, and weight management.
What are the long-term risks for children born to mothers with gestational diabetes?
Children are at higher risk of obesity, type 2 diabetes, and metabolic syndrome later in life.
How does gestational diabetes increase the risk of macrosomia?
Elevated maternal glucose crosses the placenta, stimulating fetal insulin production, leading to excessive growth (macrosomia).
What is the importance of early detection of gestational diabetes?
Early detection allows for timely management, reducing maternal and fetal complications.
What is the role of pre-pregnancy counselling for women with risk factors for gestational diabetes?
Counselling helps optimise weight, blood glucose levels, and overall health before conception, reducing the risk of gestational diabetes.
How is polyhydramnios related to gestational diabetes?
Polyhydramnios can occur due to fetal polyuria from hyperglycaemia, increasing the risk of preterm labour and delivery complications.
