Gestational Diabetes Flashcards
In normal early pregnancy, does insulin response increase or decrease and why?
Increases
-Because of the growth of the placenta and an increased maternal fat storage
In normal late pregnancy, does insulin sensitivity increase or decrease and why?
Decreases
-Because the fetus grows very quickly
-Nutrients is shunted away from the mother to the fetus (so mother becomes insulin resistant and does not take up as much nutrients)
In a normal pregnancy, how is late pregnancy- reduced insulin sensitivity compensated?
Increased insulin secretion by the mother
(keeps blood glucose in normal range)
What is the definition of “gestational diabetes”?
Hyperglycemia during pregnancy in otherwise non-diabetic women
When does gestational diabetes typically appear?
Around 24 weeks
(rapid growth stage of gestation)
What are the complications of gestational diabetes?
-Damage to baby during birth (because baby is extra fat)
-Neonatal hypoglycemia
-Breathing problems for baby (high glucose/insulin can delay lung maturation)
What is “fetal programming”?
When a mother has gestational diabetes, the risk of developing Type 2 diabetes later in life is increased for both the mother and the baby
Does insulin cross the placenta?
NO
Does glucose cross the placenta?
YES
-how fetus steals nutrients from mother
How are CRH (corticotropin-releasing hormone) and Cortisol suspected to cause gestational insulin resistance?
-Placental hormones that increase as pregnancy progresses
-Glucocorticoids oppose insulin action
Which hormones (Besides CRH and Cortisol) that are released from the placenta, are suspected to contribute to gestational insulin resistance?
Progesterone
Placental GH (GH-v)
Placental Lactogens (PL)
Which two hormones increase beta-cell mass during pregnancy?
Prolactin
Placental lactogen
What are the two components to treatment of gestational diabetes?
Diet and Medications
How should a patient with gestational diabetes adjust their diet?
-Eat small meals with complex carbs
-Avoid sugary foods
What is the gold standard medication used in treating gestational diabetes patients?
Insulin
