Endocrine and Metabolic Disorders Flashcards
(47 cards)
Definition of Gestational Diabetes
any degree of glucose intolerance with onset or recognition during pregnancy (due to the body dealing with the baby)
What is the risk factors of Diabetes type 2
Obesity, Aging, Sedentary lifestyle, HTN, and prior gestational diabetes
What is White Classification of GDM: GOOD
A-C
What is White’s classification of GDM: vascular complications
D F R T
Insulin Requirement during the1st trimester
Insulin production increased -> peripheral use of insulin -> results in decreased blood glucose
NV (hypergravidemism) drop in mother’s glucose
HPL (human placental lactogen) is secreted = insulin antagonist
Insulin Requirements in 2nd and 3rd trimesters
Insulin requirement ^ 4x
abrupt drop of hormones and return to prepregnant state
- Insulin needs decrease
Maternal Risks of Complication GDM
Worsening of pre-existing disease -> vascular problems -> retinopathy
Hypoglycemia 1st half of pregnancy
Hyperglycemia -> ketoacidosis 2-3rd trimesters
Preeclampsia and eclampsia
Polyhydramnios in 10-20% of diabetic
Dystocia *C-section
When does the baby pancreas create it own insulin
10 wks gestation
Effects on fetal GDM (most common)
Macrosomia r/t excess glucose from Mom
Large for gestational age (LGA) >4000g
More effects on fetal GDM
IUGR= maternal vascular involvement
Delayed lung maturity -> respiratory distress syndrome
Hypoglycemia after birth
Congenital anomalies (NTD and SD)
Read slide about screening and testing for GDM
Values of OGGT (Testing for Diabetes)
FBS <95 mg/dl
1 hr <180mg/dl
2 hr <155 mg/dl
3 hr <140 mg/dl
What is the management of DM during pregnancy
Insulin therapy, exercise, glucose monitoring, diet
What should be the target range for Premeal/Fasting (Managing Glucose)
> 65 mg/dL but <105 mg/dl
What is the recommended meals and snacks for a GDM
3 meals and 2-3 snacks
How much carbo should the pt intake?
no more than 55%
For a night snack, what should be recommended
protein and at least 25g complex carb
Do you need foods before taking insulin
YES
Exercise GDM
30-60 mins walking or swimming a day
10-20 mins period throughout the day
Snack of protein or complex CHO before exercise
Monitor glucose before and after
Insulin therapy
2/3 of daily insulin at breakfast -> combination of intermediate or long acting and shorting acting insulin
1/3 of daily insulin in the evening -> combination of long-acting and short-acting insulin
Risk Factors of Hypoglycemia
Too little food
Too large insulin dose
Stress= ^ sugar
Illness/Vomiting or diarrhea
Exercise
Symptoms of Hypoglycemia
Nervousness
HA
Shaking/irritable
Hunger
blurred vision
Diaphoresis
Treatment of Hypoglycemia
Check blood glucose
<70 mg/dL eat or drink 8-16g of Cho (hard candy, skim milk, unsweetened OJ, soda
Rest 15 mins -> recheck glucose
Notify caregiver if continues
If it is greater, provide a meal with protein
Signs and Symptoms Hyperglycemia
Glucose >130 mg/dl
Ketones in urine
Dry and flushed skin
Polyuria, polydipsia
Kussmaul respirations *regular insulin
DKA-medical emergency
