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Flashcards in Diabetes in Pregnancy Deck (25)
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1

when do levels of luteinising hormone peak in the cycle of ovulation

around day 14, just before ovulation

2

what is the follicle called after ovulation

corpus luteum

3

what is produced by the corpus luteum

progesterone (and oestradiol)

4

what is produced by the follicle

oestradiol

5

what hormone is produced if implantation of the corpus luteum occurs

HCG(this is what is tested for in pregnancy test)

6

what are the 3 main hormones produced by the placenta in pregnancy

human placental lactogen(hPL), placental progesterone, placental oestrogens

7

what is produced by the pituitary in pregnancy

prolactin(lactogen), needed to produce milk

8

what hormones play a role in increased insulin resistance in pregnancy

hPL and placental progesterones

9

what can happen if a pregnant women is already predisposed to insulin resistance before being pregnant

raised blood glucose and gestational diabetes

10

what are the 3 types of diabetes see in pregnancy

T1DM, T2DM and gestational diabetes

11

when does foetal organogenesis occur in pregnanacy

starts at ~5 weeks, possibly earlier

12

what complications can arise in pregnancy as a result of T1 or T2DM

congenital malformation, prematurity, intra-uterine growth retardation(IUGR)

13

what complications of pregnancy are specific to congenital diabetes

macrosomia(large baby weight/size), polyhydramnios, intrauterine death

14

what complications can arise in the neonate from diabetes

resp. distress(immature lungs), hypoglycaemia(fits), hypocalcaemia(fits), CNS defects, skeletal abnormaltities, ureteric duplication

15

when does the foetus begin producing its own insulin and what effect does this have

in 3rd trimester, insulin is a MAJOR growth factor

16

describe how diabetes in pregnancy can affect foetal growth

maternal hyperglycaemia results in foetal hyperglycaemia, and then foetal hyperinsulinaemia which then result sin macrosomia
(as well as neonatal hypoglycaemia)

17

what pharmacological management should be used for pregnant T1DM and T2DM patients

folic acid 5mg, avoid ACEi and statins, for BP eg use Labetalol, start aspirin 12mg at 12 weeks

18

what non-pharmacological management should be used for pregnant T1DM and T2DM patients

pre-pregnancy counselling(ie good sugar control pre-conception!), regular eye checks

19

what non-pharmacological treatment should be used for T1DM, T2DM and gestational diabetes

diabetic diet, good blood glucose control, continuous glucose monitoring, monitor HbA1c, BP

20

what drug treatment is used for T1DM during pregnancy

insulin

21

what drug treatment is used for T2DM during pregnancy

metformin, will probs need insulin later on

22

what drug treatment is used during gestational diabetes

metformin, may need insulin

23

what follow up of gestational diabetes should be done

6 week post natal fasting glucose, ensures resolution of gestational or diagnosis of T2DM

24

what lifestyle measures are used to prevent development of diabetes after gestational diabetes

keep weight low as possible, healthy diet, aerobic exercise, annual fasting glucose measures

25

what % of people with gestational diabetes go on to develop T1 or T2DM

T1DM = <5%
T2DM = around 50% in 10-15 years after pregnancy