Gestational Diabetes
Terms
undefined, object
copy deck
- What % of pregnancies are complicated with GDM?
- 4%
- True or False: GDM is more likely to occur in hispanic, native american, asian or african americans.
- True
- When are most women diagnosed with GDM?
- 2nd and 3rd trimester when fetal nutrion demands rise, maternal insulin resistance is increased, and maternal insulin demands rise 3x
- The woman is flushed, skin is hot she has dry mouth and is excessively thirsty, having rapid deep inspirations what is she exhibiting signs of?
- Hyperglycemia
- The woman is showing signs of hypoglycemia what would you expect her blood glucose to be?
- less than 60 mg/dl
- The woman is having shallow respirations, cold and clammy skin, disoriented, with blurry vision what are these symptoms typical of:
- hypoglycemia
- why does insulin resistance increase?
- insulin antagonistic effects of the placental hormones- cortisol and insulinase.
- if the woman is diagnosed in the first trimester with GDM what is the main concern?
- because the fetus is in critical period of organogenisis congenital anomolies may occur
- 2 major risks of GDM are:
-
hypertensive disorders- risk doubles
fetal macrosomia- cesarian, shoulder dystocia and birth trauma. - Fasting glucose is normal but GTT- glucose tolerance test is abnormal. how do you treat the condition?
- diet
- Abnormal GTT and elevated fasting glucose is controlled by:
- insulin
- GTT in a low risk woman is done at -----weeks of gestation
- 24-28
- The neonate is at increased risk for what further complications?
- hypoglycemia, hypocalcemia, hyperbilirubinemia, thrombocytopenia,polycythemia and respiratory distress syndrome
- For the avg woman the glucola test consists of and does the woman have to be fasting?
- 50 g oral glucose load followed by plasma glucose determination 1 hour later.
- what is a positive glucola test?
- over 140 mg/dl
- T or F: the 3hour OGTT (oral glucose tolerance test) is given routinely at the 24th week office visit.
- False: only if the 1hour test is positive. the 3 hour test is given after a 12hour fast and after 3 days of unrestricted diet.
- what may give the test a false positive?
- caffiene intake
- How many of the values have to meet or exceed 'normal' for diagnosis of GDM?
- 2 of the 4 values have to meet or exceed the norm
- The goal of therapy for woman with GDM is strict blood glucose control. what are acceptable levels?
-
fasting less than 105 mg/dl
2 hrs post-prandial less than 120 mg/dl - what is the diabetic diet?
- 30-35 kcal/kg of present preg. weight- 2000-2500/day. careful choices of what those calories consist of.
- T or F: exercise is instrumental in lowering blood glucose and eliminating need for insulin.
- True
- how often should Blood glucose monitoring happen in woman diagnosed with GDM?
- At least weekly.
- What special tests for fetal monitoring are done if mother is on insulin or has other complications such as hypertension or previous still birth?
- non-stress test and biophysical profile weekly
- during labor and delivery how often is blood glucose level checked? what should it be?
- every 2 hours, less than 100mg/dl to minimize risk of hypoglycemia in neonate
- when can woman be assessed for glucose levels post-partum?
- 4-6 weeks or after breastfeeding has stopped.
- what is the percentage of recurrance for GDM?
- 50%