Some risks associated with Gestational Diabetes to the mother
What are preeclampsia (9.8%>18%), Cesarean Delivery( 9.5%>17%>25%)
True/False: It is appropriate to continue this metformin if a patient was on it prior to pregnancy for PCOS
True
Appropriate first line therapy for GDM
What is insulin (preferred) or metformin
NOT glyburide
-evidence indicates that glyburide treatment should not be recommended as a first-choice pharmacologic treatment because, in most studies, it does not yield equivalent outcomes to insulin or metformin.
The percentage of pregnancies complicated by diabetes (either gestational or pregestational)
What is 7%
BMI at which early screening is indicated
What is 40?
OR BMI 25 with at least one other risk factors: 1 deg family or personal history of diabetes, HTN, cardiovascular disease, high cholesterol, PCOS, high risk ethnicity, previous birth >4000g, etc
Screening test for GDM women 4-12 weeks postpartum
What is 75g load 2 hour OGTT?
Percentage of women who will develop diabetes later in life if they had GDM
What is up to 70% (within 22-28 years)
Bonus: 60% of latina patients will develop DM within 5 years from index pregnancy
How to monitor GDM postpartum
What is 2-hr GTT 4-12 weeks postpartum
When to repeat screen for diabetes if postpartum testing is normal?
The ADA and ACOG recommend repeat testing every 1–3 years for women who had a pregnancy affected by GDM and normal postpartum screening test results.
Weight-based dose for starting insulin?
What is typical starting total dosage is 0.7–1.0 units/kg daily. This dosage should be divided with a regimen of multiple injections using long-acting or intermediate-acting insulin in combination with short-acting insulin.
What is MOA of glyburide
What is increase insulin secretion and insulin sensitivity of peripheral tissues at pancreatic beta-cells