gestational diabetes

Question 1

what are the risks associated with high blood glucose during pregnancy

Answer 1

pre-eclampsia, rapidly worsening retinopathy, miscarriage, congenital malformation, stillbirth, and neonatal death

Question 2

what is the only ORAL antidiabetic that can be used during pregnancy + breastfeeding

Answer 2

metformin

Question 3

what is the treatment for gestational diabetes

Answer 3

can only use metformin and/or insulin
eg:
- metformin only
- metformin + insulin
- insulin only

Question 4

what is the first-choice for long-acting insulin during pregnancy

Answer 4

Isophane insulin (brand names: Humulin / Insulatard / Insuman)

note: if a woman had good blood-glucose control with other insulins before pregnancy, it may be appropriate to continue them during pregnancy

Question 5

why should pregnant women always carry a fast-acting form of glucose, such as dextrose tablets or a glucose-containing drink

Answer 5

during pregnancy they should be aware of the risks of hypoglycaemia, particularly in the first trimester

Question 6

how is the dose of insulin affected after birth in women with pre-existing diabetes

Answer 6

dose of insulin should be reduced immediately after birth (this is because during pregnancy, you need to increase insulin)

Question 7

if a pregnant women with gestational diabetes has a fasting blood glucose ABOVE 7mmol/litre, what treatment should they have

Answer 7

insulin (with or without metformin)

*note also need to change diet + exercise)

Question 8

if a pregnant women with gestational diabetes has a fasting blood glucose BELOW 7mmol/litre, what treatment should they have

Answer 8

metformin (insulin may be added or insulin used alone if metformin not tolerated)