DM in Pregnancy

Question 1

pregest DM Timing of delivery: well controlled

Answer 1

full term (~39w-39w6d)

Question 2

pre-gest DM, timing of delivery: poorly controlled

Answer 2

36-38w6d

Question 3

gest DM, well-controlled (diet)

Answer 3

full-term (39w-40w6d)

Question 4

gest DM, well-controlled (meds)

Answer 4

full-term (39w-39w6d)

Question 5

Poorly controlled GDM

Answer 5

late preterm / early term
(individualized)

Question 6

DKA findings

Answer 6

1. arterial pH <7.3
2. low bicarb <15
3. elev anion gap
4. • serum ketones

Question 7

DKA mgmt: IV fluids

Answer 7

1. NS 0.9%
2. NS .45% if sodium elevated
   2.** glucose <200mg/dL**: 5% dextrose w/ 0.45% NS

Question 8

DKA mgmt: Potassium
-goal
-high vs low

Answer 8

goal: b/t 3.3-5.3
low (<3.3): hold insulin, give K
high (>5.3): check K q2hrs

Question 9

DKA Mgmt: Insulin
-loading dose
-maintenance

Answer 9

loading: 0.1-0.2 U/kg
continuous: 0.1 (reduce to 0.05 when glucose <200mg/dL)