Diabetes in pregnancy

Question 1

What percentage of women w gestational diabetes have no risk factors (age, obesity, family, history, prior stillbirth or anomaly)

Answer 1

56%

Question 2

ADA calorie suggestion for gestational diabetes

Answer 2

35 calories/kg (ideal body wt)

Ex. Weight 70kg x 35 cal/kg = 2100

Question 3

ADA recommended calories expenditure for gestational diabetes

Answer 3

Breakfast 25%
Lunch 30%
Dinner 30%
Evening/bedtime snack 15%

Question 4

Macronutrient breakdown for gestational diabetes

Answer 4

Protein 15-30% (4kcal/gram)
CHO 40-50% (4kcal/gram)
Fat 25-35% (9kcal/gram)

Question 5

Multiplier for insulin in the first trimester

Answer 5

0.5

Ex 80kg x 0.5 = 40 units of total insulin needed per day

Question 6

Multiplier for insulin in the second trimester

Answer 6

0.7

Ex 80kg x 0.7 = 56 units of total insulin needed per day

Question 7

Multiplier for insulin in the third trimester

Answer 7

0.9

Ex 80kg x 0.9 = 72 units of total insulin needed per day

Question 8

How is total insulin given per day divided?

Answer 8

2/3 in the AM and 1/3 in the PM

Question 9

How is AM insulin divided between long acting (ex NPH) and short acting (ex Aspart)?

Answer 9

2/3 Long acting (6 hrs) and 2/3 short acting (2 hrs)

Question 10

How is PM insulin divided between long acting (ex NPH) and short acting (ex Aspart)?

Answer 10

1/2 long acting (6hrs) and 1/2 short acting (2hrs)