Gestational Diabetes

Question 1

What is gestational diabetes?

Answer 1

High blood sugar levels that develop during pregnancy.

Question 2

What is the pathology of gestational diabetes? (simple answer)

Answer 2

If a mother’s body cannot produce enough insulin to meet the extra needs during pregnancy.

Question 3

Who does gestational diabetes affect?

Answer 3

Both mother and baby.

Question 4

How can having diabetes effect the overall size of baby?

Answer 4

The baby may have macrosomia.

This may lead to a complicated birth.

Question 5

What are the symptoms of gestational diabetes?

Answer 5

Most women don’t show symptoms.

Usually only diagnosed in routine blood tests throughout pregnancy.

Question 6

What risk factors mean that a mother is at risk of having gestational diabetes? (3)

Answer 6

• High BMI (>30)
• FHx of Diabetes
• Part of high risk demographic for DM
  (i. e. asian, poor)

Question 7

What information from previous pregnancies may suggest an increased risk of gestational diabetes? (4)

Answer 7

• Previous Gestational DM.
• Previous macrosomic baby.
• Polyhydramnios during pregnancy.
• Recurrent glycosuria during pregnancy

Question 8

What is glycosuria?

Answer 8

Excess sugar in urine.

Question 9

What constitutes as macrosomia?

Answer 9

Baby weight over 4.5kg

Question 10

What complications may arise during PREGNANCY, regarding BABY, due to gestational diabetes? (3)

Answer 10

• Foetal macrosomia
• Polyhydramnios
• Foetal congenital abnormalities

Question 11

What complications may arise during PREGNANCY, regarding MOTHER, due to gestational diabetes? (6)

Answer 11

• Pre Eclampsia
• Hypoglycaemia
• Reduced awareness of hypoglycaemia
• Infections
• Retinopathy
• Exacerbation of neuropathies

Question 12

What complications may arise during LABOUR, due to gestational diabetes? (3)

Answer 12

• Stillbirth
• Shoulder dystocia
• Operative delivery

Question 13

What complications may arise after birth (neonatal), due to gestational diabetes? (3)

Answer 13

• Impaired lung maturity
• Neonatal hypoglycaemia
• Jaundice

Question 14

What do we do if a woman has a risk factor for gestational diabetes? (3 steps 2 tests)

Answer 14

1) Offer HbA1C test
2) if HbA1C is above 43 mmol/mol, conduct OGTT
3) If OGTT is normal, repeat at 24-28 weeks. (or more even at 16 weeks if significant risk factors present)

Question 15

What is HbA1c?

Answer 15

Average blood glucose levels for previous two months.

Question 16

What is the normal level for HbA1c? (mol/mmol and %)

Answer 16

Below 42

4.0% - 5.6%

Question 17

What is a pre-diabetic HbA1c level? (mol/mmol and %)

Answer 17

43 - 47

5.7% - 6.4%

Question 18

What is a diabetic HbA1c level? (mol/mmol and %)

Answer 18

Over 47

over 6.4%

Question 19

What is OGTT?

Answer 19

Oral Glucose Tolerance Test

Give 75mgs of glucose.
Blood samples taken an hour after to see how quickly glucose is cleared from blood.

Question 20

How do we keep track of gestational diabetes?

Answer 20

Monitor blood glucose levels.

CTG during labour / pregnancy

Question 21

What is CTG?

Answer 21

Records fetal heartbeat and uterine contractions.

Question 22

How do we manage gestational diabetes?

Answer 22

• Control diet
• Metormin
• Insulin if sugars remain high

Question 23

What do we do to monitor a mother with gestational diabetes post-delivery?

Answer 23

• Check OGTT 6 to 8 weeks post-delivery

- Yearly Hb1Ac check (due to higher risk of developing DM)