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Diabetes in Pregnancy > Practice > Flashcards

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1
Q

What OGTT, Polycose + HbA1c results would indicate GDM?

A

OGTT Fasting: >/=5.5 mmol/L
OGTT 2hr >/=9 mmol/L

Polycose 1 hr >11

HbA1c >=50 mmol/L

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2
Q

Routine diabetes screening for low risk pregnant woman?

A

HbA1c with booking bloods. If normal HbA1c & no GDM risk factors, polycose at 24-28wk. Discuss option of diagnostic OGTT test.

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3
Q

How often is a polycose falsely normal in women with GDM?

A

25%

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4
Q

Clinical indications for OGTT after 30 weeks?

A

Macrosomia or polyhydramnios. If after 32wks, consult

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5
Q

Risk factors for GDM? (11)

A
  1. PCOS
  2. Chronic hypertension
  3. Steriod or antipsychotic meds
  4. Family history of diabetes
  5. Glycosuria
  6. Macrosomia
  7. HbA1c 41-19
  8. Prev GDM/macrosomia/PET/perinatal loss/preterm birth
  9. Over 30
  10. Excessive weight gain in pregnancy
  11. Ethnicity
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6
Q

Meds for T1/T2DM for PET prevention?

A

5mg folic acid, Aspirin + calcium

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7
Q

What are the glucose targets

A

Fasting <5
1hr <7
2hr post prandial <6-6.5
(nb T1D may have modified targets)

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8
Q

When should metformin be avoided (4)?

A

If there is significant IUGR, ongoing maternal weight loss, PET or significant GI upset.

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9
Q

Maternal complications of GDM (6)?

A
  1. PET/Hypertensive disorders
  2. Birth trauma
  3. LSCS
  4. UTI
  5. Increased risk T2D
  6. Need for IOL
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10
Q

Are brands of insulin interchangeable?

A

No.

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11
Q

Care for T1D intrapartum

A

Glucose/Insulin infusion and follow protocol for testing BSLs and adjusting rate

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12
Q

Care for GDM (diet/metformin) intrapartum

A

Monitor glucose 2hrly

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13
Q

What is the follow up for GDM patients postpartum?

A

HbA1c @ 3months PP, then annually

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14
Q

Define hypoglycaemia:

A

CBG <4 (some say 3.5)

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15
Q

Symptoms of hypoglycaemia (12)

A

Sweating, dizziness, rapid HR, shaking, anxiety, weakness/fatigue, confusion, irritability, hunger, pins and needles in lips/tongue, impaired vision, headache.

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16
Q

Diet composition for diabetes:

A

<10% saturated or polyunsaturated fat
15-20% Protein
30% Fat
50% Carbohydrate

17
Q

How often should a woman change the needle on her pricker?

A

Every 2-4days

18
Q

Should a woman eat when she is taking short or long acting insulin?

19
Q

What should women check for on an insulin vial?

A

Expiry date, cracks, floating particles

20
Q

Where should spare insulin be stored?

A

In the fridge, not in the door

21
Q

Diabetes diet basic advice

A

Healthy plate - 1/2 veggies, 1/4 protein, 1/4 carbs
Water for drinks
Don’t skip meals

Avoid foods high in saturated fat such as fatty meat, fried foods, chips, cream, mayonnaise, butter, coconut oil, coconut milk.

Avoid foods high in sugar such as lollies, chocolates, cakes, soda, cordial, sports drinks, energy drinks

You’re not eating for two, once you’re full you don’t need to force yourself to keep eating, healthy portion sizes are also important

22
Q

When does GDM usually develop (gestation)?

A

After 24wk

23
Q

What are the three forms of insulin?

A
  1. Rapid and short acting (abdo)
  2. Intermediate acting
  3. Long acting (buttocks/thighs)
24
Q

What colour are humalog rapid acting and novorapid (rapid acting)

25
Q

What colour are novomix (rapid + intermediate) and humalog mix (rapid + intermediate)

26
Q

When should treatment regime be reassessed (how many readings out of range)?

A

10% of readings above treatment targets

27
Q

At what stage of pregnancy do women become more insulin resistant?

28
Q

What are the glucose targets intrapartum?

29
Q

BSL frequency intrapartum for T2D or GDM on insulin?

30
Q

Growth scan frequency if diabetic but NO other risk factors

31
Q

How long should BSLs be monitored postnatally

A

48hrs (or until discharge)

32
Q

Symptoms of Hyperglycaemia

A

Extreme thirst, dry mouth, weakness, frequent urination, blurry vision, nausea, confusion, shortness of breath

33
Q

What are complex carbohydrates, give examples

A

Carbohydrates with more fibre + starch are complex carbs.
High fibre: fruit, vegetables, beans, grains (e.g. quinoa, buckwheat, whole wheat pasta), nuts
High starch: whole wheat bread, corn, oats, peas, rice

34
Q

What are simple carbohydrates, give examples

A

Simple carbs are sugars e.g raw sugar, fruit juice, soda, biscuits/cakes, some breakfast cereals

35
Q

What is the risk of 1st trimester hyperglycaemia for the fetus?

A

Congenital malformations

36
Q

Why does maternal hyperglycaemia cause macrosomia?

A

Insulin is a growth factor

37
Q

Why hire me? WHY BUY EXTRA MUFFINS

A

Want (the job + long term)
Badgernet (experience)
Experience
Maori

Diabetes in Pregnancy (3 decks)

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