pregnancy

Question 1

Step 1 screen (pregnant)

Answer 1

50g at 24-28 weeks, if 7.8-11 then step 2

Question 2

Step 2 screen (pregnant)

Answer 2

fasting 75g challenge
Fasting >5.3
1PP >10.6
2PP > 9
If any level is above then GDM

Question 3

GDM risk factors (9)

Answer 3

Previous GDM
previous baby
pre diabetes
glucocorticoids
polycystic ovain syndrome
south asian
>35yo
acanthuses Nigerians
BMI> 30

Question 4

Dangers of GDM to mother (3)

Answer 4

Trauma from birth
pre-eclampsia
HTN

Question 5

dangers of GDM to baby

Answer 5

trauma
prematurity
hypoglycaemia PP
immature lung function

Question 6

GDM goals of therapy

Answer 6

Fasting BG <5.3
1 hour PP <7.8
2 hour PP <6.7

Question 7

GDM lifestyle

Answer 7

first line diet if not effective after 1-2 weeks then start pharm

Question 8

GDM insulin

Answer 8

first line therapy, use any fast acting

Question 9

GDM metformin

Answer 9

Good alternative to insulin, safe but does cross the placenta

Question 10

GDM glyburide

Answer 10

alternative for women not wanting insulin where metformin isn’t an option

Question 11

post partum care

Answer 11

stop insulin as resistance will fase
test in 6weeks - 6 months with 75g