Diabetes In Pregnancy

Question 1

Diabetes mellitus

Answer 1

DM is a chronic metabolic disorder characterised by hyperglycaemia due to either insulin deficiency (relative
or absolute) or due to peripheral tissue resistance (decreased receptor sensitivity) to action of insulin.
 Defect lies both in insulin secretion and action, ultimately leading to hyperglycemia.
 Its due to:
a) Decreased sensitivity of skeletal muscles & liver to insulin (insulin resistance)
b) Inadequate secretion of insulin (β cell dysfunction)

Question 2

main types of Diabetes mellitus.

Answer 2

1. Type–1 (IDDM) - characterized by young age onset (Juvenile) & absolute insulinopenia or near absolute
   deficiency of insulin
    Formerly aka insulin dependent diabetes mellitus
    Onset is under 20 years old,
    Only 10% have a 1st degree genetic predisposition of relative affected with presence of autoantibodies
    Insulin deficiency is due to auto-destruction of pancreatic β cells.
    Not associated with obesity
2. Type–2 (NIDDM) is characterized by late age onset, overweight woman and peripheral tissue (skeletal muscle,
   liver) insulin resistance (hyper insulinemia).
    Due tp relative insulin deficiency and decreased insulin sensitivity.
    Typically presents in over 20 years old,
    60% have a 1st degree genetic predisposition of affected relative
    Strongly associated with obesity

Question 3

Priscilla White classification of diabetes during pregnancy - GDM and pregestational diabetes.

Answer 3

 Aids to assess disease severity and the likelihood of complications
 Poor glycemic control and vasculopathy increase risk of complication like IUD, IUGR, PE and DKA
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Question 4

Gestational diabetes mellitus (GDM)