Week 5 - A - diabetes and endocrine pregnancy Flashcards
What are the two phases of the ovarian cycle and what occurs between the two phases?
Stage 1 - follicular phase
Stage 2 - luteal phase
ovulation occurs in the midde
What is the structure than implants in the uterus? What does the corpus luteum secrete and why?
The egg implants in the uterus
The corpus luteum primary function is to secrete progesterone to prepare the potential implantation of a fertilised egg
What is the corpus luteum?
Yellow, progesterone-secreting mass of cells that forms from an ovarian follicle after the release of a mature egg
What is the hormone produced by the placenta that helps break down fat for the growing baby?
Human placental lactogen (hPL)
What can Human placental lactogen (hPL) lead to in the mother?
Can cause insulin resistance and carbohydrate intolerance in the mother
What trimester does gestational diabetes most commonly occur in? What diabetes can GDM predispose to?
The third trimester of gestation
Can predispose to type II diabetes mellitus
What is the ptential preganncy complication known as where the baby is very large and weighs more than 8pounds 13ounces (4 kg)?
Macrosomia
How does maternal hyperglycaemia lead to a possible macrosomia?
Maternal hyperglycaemia will cause a foetal hyperglycaemia which will cause a foetal hyperinsulinaemia leading to increased foetal growth causing macrosomia
When does the foetus begin to produce its own insulin?
In 3rd trimester foetus produces own insulin which is a MAJOR growth factor
With maternal hyperglycaemia potentially leading to foetal hyperinsulinaemia, what can this cause to the neonate?
Can potentially cause neonatal hypoglycaemia
In a non-diabetes pregnancy what vitamin is given?
Vitamin B9 - folic acid
During labour, how should the blood sugar levels be maintained in a diabetic?
Sliding scale of insulin - IV insulin and IV dextrose
What is the treatment for maturity onset diabetes of the young? (both glucokinase and HNF1a mutations)
MODY - strong family history and early age of onset (25)
Mutations in glucokinase enzyme can usually be diet controlled
* Mutations in HNF1a has a rule of thirds:
* 1/3rd diet, 1/3rd sulphonylureas, 1/3rd insulin
In a patients with type 2 diabetes, what test is done 6weekspost natally to decided if the patient has T2DM?
6week post natal GTT - to ensure resolution of DM - If not they have T2DM
Gestational diabetes usually presents in the first trimester True or false?
False - usually occurs in third trimester
Alpha 2 agonist used in pregnant women with hypertension
Methyldopa
