Pregnancy And Diabetes Flashcards
Gestational diabetes?
Diabetes or impaired glucose: fasting glucose equal or more 5.6
2 hour GTT glucose over or equal 7.8
In early pregnancy, facilitated anabolism?
Increased insulin sensitivity
And lower glucose conc, increased maternal energy stores
In later pregnancy facilitated catabolism?
Increased insulin resistance and increased transplacental passage of nutrients so rapid fetal growth
Abnormal placental programming?
Increased risk of pre eclampsia and excessive glucose transport
Diabetes control in 1st semester treatment?
Insulin regimen, lifestyle modification, folic acid 5mg/day, glucose monitoring
Shoulder dystocia?
Shoulder gets stuck
How many women at antenatal booking is obese?
1 in 5
Treatment of hyperglycaemia?
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
Targets for hyperglycamia?
1 hour postprandial less than 7
Fasting less than 5.1
Fetal abdominal girth less than 70th centile
Gestational diabetes treatment?
Metformin
Basal insulin
Basal bolus insulin
Glibenclamide
What is gestational diabetes?
Any abnormal glucose tolerance presenting after 1st trimester of pregnancy
1st semester malformations?
Single ventricle and sacral dysgeisnesis Hydrocephalus Meningomyocele Central cyanosis Renal agenesis
Risk factors of IGT and diabetes?
PCOS
Fam history of type 2
Obesity
Previous gestational diabetes
Problems with macrosomia?
Difficult birth Shoulder dystocia Breathing problems Jaundice Hypoglycaemia
Increased perinatal mortality?
Type 2 x9
Type 1 x4
Screening for GD?
Obesity over 30 PCOS Obesity Fam his High risk racial Previous GD Older age at booking
Then test at 26-28 weeks
Drug treatment for prepregnancy and 1st trimester hyperglycaamia?
Basal bolus regimen
Breastfeeding reduces diabetes in children?
30-50% of risk
Prolonged exclusive 67%
Post partum GDM managment
Antibody status
Screen diabetes 12 weeks hba1c and fasting glucose
Advice
Annual glucose screening
What percent of women with gd get type 2 at 10 years?
50%
What is the definition of gestational diabetes?
Any newly found abnormal glucose tolerance tests after the 1st trimester of pregnancy
First trimester problems?
Hydrocephalus Menoingomyelocoele Central cyanosis in CHD Single ventricle and sacral dysgenesis Renal agenesis
What should you check for in women in terms of risk factors with unknown cases of diabetes/IGT?
Previous gestational diabetes Fam history Obesity PCOS High risk racial group
What are the problems with macrosomia?
Difficult birth Shoulder dystocia Breathing problems Jaundice Hypoglycaemia
