Gestational Diabetes Mellitus (GDM)

Question 1

how is GDM defined?

Answer 1

defined as elevated glucose levels that are first recognized during pregnancy

Question 2

In first trimester of pregnancy, uncontrolled hyperglycemia can affect what?

Answer 2

fetal development, resulting in malformations

Question 3

Patients with GDM are at significant risk of developing what later in life?

Answer 3

glucose intolerance

Question 4

Patients whose GDM is diagnosed early in pregnancy and who may be obese are at increased risk of:

Answer 4

sustained glucose intolerance and type 2 diabetes

Question 5

complications of GDM?

Answer 5

pre-eclampsia or having a birth with shoulder dystocia, a Caesarean birth, or a LGA

Question 6

GDM places the fetus at increased risk for:

Answer 6

hypoglycemia, IUGR(intrauterine growth restriction) (related to poor placental function), and intrauterine fetal death

Question 7

is hyperglycaemia difficult to detect?

Answer 7

yes

Question 8

when should pregnant patients should be screened for the presence of GDM?

Answer 8

24 to 28 weeks of gestation

Question 9

when should pregnant patients be screened early (1st trimester) for hyperglycaemia?

Answer 9

if have extra risk factors

Question 10

Risk factors for the development of GDM include:

Answer 10

Being 35 years of age or older
Being a member of a high-risk group (African, Arab, Asian, Latin-
American, Indigenous, or South Asian)
Using corticosteroid medication
Obesity (a body mass index [BMI] greater than or equal to 30)
Pregestational diabetes
Gestational diabetes in a previous pregnancy
Given birth to a baby that weighed more than 4 kg
A parent, brother, or sister with type 2 diabetes
Polycystic ovary syndrome or acanthosis nigricans (darkened
patches of skin).

Question 10

If the initial screening (early screening) is performed before 24 weeks of gestation and is negative, when should there be a re screening?

Answer 10

between 24 and 28 weeks of gestation

Question 11

Fasting (preprandial) blood glucose levels should be between:

Answer 11

3.8 and 5.2 mmol/L

Question 12

1 hour after meals (postprandial) blood glucose levels should be between:

Answer 12

5.5 and 7.7 mmol/L

Question 13

2-hour postprandial blood glucose levels should be between:

Answer 13

5.0 and 6.6 mmol/L