Gestational Diabetes Flashcards
(14 cards)
Define Gestational Diabetes
glucose intolerance that develops during pregnancy
NICE Gestational DM Dx criteria
- Fasting glucose >5.6 mmol/L
- 2h OGTT glucose >7.8 mmol/L
Gestational DM Diagnostic test
75g oral glucose tolerance test (OGTT)
At what geatational weeks should the OGTT be performed
24-28 wks
Gestational DM risk factors
- BMI >30
- Prev. macrosomic baby 4.5kg or above
- Previous gestational diabetes.
- First degree relative with diabetes.
- South Asian, black Carribbean, Middle Eastern
Gestational DM complications
- Fetal macrosomia
- Preterm labour
- Shoulder dystocia
- Polyhydramnios
- Pre-eclampsia
- Still birth
- high risk for developing T2DM
- Neonatal hypoglycaemia
Gestational DM Sx
- Polydipsia
- Polyuria
- A dry mouth
- genital itching / thrush
- hyperglycaemia
Gestational DM blood glucose targets
For metformin/lifestyle
Fasting: 5.3 mmol/L
1h post meals: 7.8 mmol/L
2h post meals: 6.4 mmol/L
For insulin
≥4 mmol/L
Gestational DM management
stepwise Mx
Fasting plasma glucose 5.6 - 7:
1st line: 1-2/52 trial of diet and exercise changes
2nd line: if BM is still above 5.3, start metformin OR if BM is above 7 or metformin is contraindicated - start insulin therapy
when is OGTT offered in women with previous Hx of GDM
ASAP
when should women with GDM give birth no later than
40+6 wks
when should medication be stopped in GDM
immediately post-delivery
GDM maternal complications
- HTN
- Worsening microvascular disease
- Future T2DM
- Postpartum haemorrhage
- Ketoacidosis
- Increase caesarean rate
GDM Fetal complications
- Macrosomia >4.5 kg
- shoulder dystocia
- Resp distress syndrome
- Large-for-gestational age
- Jaundice
