Pregnancy And Diabetes

Question 1

Gestational diabetes?

Answer 1

Diabetes or impaired glucose: fasting glucose equal or more 5.6

2 hour GTT glucose over or equal 7.8

Question 2

In early pregnancy, facilitated anabolism?

Answer 2

Increased insulin sensitivity

And lower glucose conc, increased maternal energy stores

Question 3

In later pregnancy facilitated catabolism?

Answer 3

Increased insulin resistance and increased transplacental passage of nutrients so rapid fetal growth

Question 4

Abnormal placental programming?

Answer 4

Increased risk of pre eclampsia and excessive glucose transport

Question 5

Diabetes control in 1st semester treatment?

Answer 5

Insulin regimen, lifestyle modification, folic acid 5mg/day, glucose monitoring

Question 6

Shoulder dystocia?

Answer 6

Shoulder gets stuck

Question 7

How many women at antenatal booking is obese?

Answer 7

1 in 5

Question 8

Treatment of hyperglycaemia?

Answer 8

Glucose monitoring, finger prick tests, fasting 1 hour
Freestyle libre
Nutrition and exercise
Ultrasound fetal abdominal girth monthly from 28 weeks
Mother’s to observe fetal movements

Question 9

Targets for hyperglycamia?

Answer 9

1 hour postprandial less than 7
Fasting less than 5.1
Fetal abdominal girth less than 70th centile

Question 10

Gestational diabetes treatment?

Answer 10

Metformin
Basal insulin
Basal bolus insulin
Glibenclamide

Question 11

What is gestational diabetes?

Answer 11

Any abnormal glucose tolerance presenting after 1st trimester of pregnancy

Question 12

1st semester malformations?

Answer 12

Single ventricle and sacral dysgeisnesis
Hydrocephalus
Meningomyocele
Central cyanosis
Renal agenesis

Question 13

Risk factors of IGT and diabetes?

Answer 13

PCOS
Fam history of type 2
Obesity
Previous gestational diabetes

Question 14

Problems with macrosomia?

Answer 14

Difficult birth
Shoulder dystocia
Breathing problems
Jaundice
Hypoglycaemia

Question 15

Increased perinatal mortality?

Answer 15

Type 2 x9

Type 1 x4

Question 16

Screening for GD?

Answer 16

Obesity over 30
PCOS
Obesity
Fam his
High risk racial
Previous GD
Older age at booking

Then test at 26-28 weeks

Question 17

Drug treatment for prepregnancy and 1st trimester hyperglycaamia?

Answer 17

Basal bolus regimen

Question 18

Breastfeeding reduces diabetes in children?

Answer 18

30-50% of risk

Prolonged exclusive 67%

Question 19

Post partum GDM managment

Answer 19

Antibody status
Screen diabetes 12 weeks hba1c and fasting glucose
Advice
Annual glucose screening

Question 20

What percent of women with gd get type 2 at 10 years?

Answer 20

50%

Question 21

What is the definition of gestational diabetes?

Answer 21

Any newly found abnormal glucose tolerance tests after the 1st trimester of pregnancy

Question 22

First trimester problems?

Answer 22

Hydrocephalus
Menoingomyelocoele
Central cyanosis in CHD
Single ventricle and sacral dysgenesis
Renal agenesis

Question 23

What should you check for in women in terms of risk factors with unknown cases of diabetes/IGT?

Answer 23

Previous gestational diabetes
Fam history
Obesity 
PCOS
High risk racial group

Question 24

What are the problems with macrosomia?

Answer 24

Difficult birth
Shoulder dystocia 
Breathing problems
Jaundice
Hypoglycaemia

Question 25

Contraception and diabetes?

Answer 25

Progestagen only pill
Combined OCP ( low dose) after 6 weeks
Mirena Intrauterine system
Sterilisation / Vasectomy

Question 26

You should give pregnant woman in first trimester?

Answer 26

Folic acid 5mg

Aspirin 150 mg/day