The Basics
The goal for any diabetic woman during pregnancy
What is blood sugars with in the normal range?
Screening for GDDM is generally done during this gestational period
What is 24-28 weeks gestation?
Name three maternal risks of poorly controlled DM (health risks in pregnancy and outside of pregnancy)
What are DKA, retinopathy, nephropathy, neuropathy, infection, preeclampsia, HTN, Preterm delivery, stillbirth
Diabetic patients are at an increased risk for these 2 types of delivery
What is cesarean or instrument assisted?
Name 2 risk factors for DKA during pregnancy
What are infection, undiagnosed GDM, poor compliance, insulin pump failure, and antenatal corticosteroids?
Pregnancy is characterized by decreased insulin resistance.
What is False?
Caloric requirements during pregnancy are an additional ____ and when breastfeeding an additional ________
What is 300 kcal/day and 500 kcal/day
Predelivery insulin requirements decrease by about this amount after delivery
What is 50%?
During labor, glucose levels should be checked how often for patients with pre-gestational diabetes
What is hourly?
Patients with diabetes are at a higher risk of shoulder dystocia due to
What is excessive fetal growth particularly in adipose tissue around the fetal shoulders and chest?
Type 1 pre-gestational diabetes mellitus is characterized by
What is an autoimmune process that destroys pancreatic B cells and therefore an inability to produce insulin?
Common fetal growth patterns during pregnancy for diabetic patients
What is large for gestational age or macrosomia?
The fasting fingerstick goal for pregnant diabetic patients is
What is less than 95mg/dl?
Fetal heart tracing characteristics commonly seen when patients are in DKA
What is minimal variability and late or variable decelerations in the presence of contractions?
Symptoms of DKA in pregnancy are
abdominal pain, nausea, vomiting, and altered mental status
Insulin requirements increase the most during this trimester
What is the 3rd?
Postpartum patients that had GDM should be counseled to get tested for diabetes because
What is a 50 % chance of developing type 2 diabetes?
This type of consult may be required for during the postpartum period
What is lactation?
The appropriate timing for delivery by a diabetic patient that is well controlled
What is between 39 -39.6 weeks?
Treatment of DKA during pregnancy focuses on
What is Aggressive IVF hydration, replenishing potassium, administering regular insulin, and assessing the need for bicarbonate?
The 3 forms that are necessary if a patient has an insulin pump
What is the Patient managed insulin pump log form, assessment for patient managed insulin pump, and patient managed insulin pump therapy patient agreement for obstetric patients
Name 2 patient populations that should be tested for GDM before the usual 24-28 weeks
What are Severe obesity; Strong family history of type 2 diabetes; Previous history of GDM, or impaired glucose metabolism?
Name at 2 fetal complications of maternal hyperglycemia during pregnancy
What are stillbirth, fetal anomalies, or miscarriage?
Women with vascular complications or poorly controlled blood glucose should be delivered between these weeks of gestation
What is 36 and 38.7 weeks?
This condition, that is common in pregnancies complicated by diabetes, results in part from fetal polyuria
What is polyhydramnios?