Diagnosis
Three major factors that make a woman high risk for developing gestational diabetes
What are Family History, Weight, Age, Previous History, Ethnicity, Other conditions: HTN, Heart Disease, PCOS, previous A1c 5.7 or >
60-95mg/dL
Criteria for someone to qualify for a personal CGM
1) On one injection or more of insulin per day
2) And/or documented history of hypoglycemia
Recommendation for delivery in someone with A1GDM, no other complications
39-40 weeks
Typical insulin reduction required in a T1 or T2 in the immediate PP period
50-80%
The A1c range for prediabetes outside of pregnancy
5.7-6.4
Post prandial glucose target in pregnancy
1 hour: <140
2 hours: <120
Prophylactic OTC Med used for preeclampsia prevention in patient with DM in Pregnancy
162mg Baby Aspirin
Recommendation for delivery, insulin-controlled diabetes (A2s, T2s, T1s)
37-39 weeks
Insulin recommendations at time of induction/postpartum for an A2GDM
Administer last dose the night before induction (if AM induction), d/c all insulin once patient has delivered
Cheap, easy screening for method for someone at high risk for gestational diabetes in the first trimester
A1c
When on CGM, the TIR target for someone with gestational diabetes
90% or more
ACOG u/kg dosing guidance by trimester
1st: .6u/kg
2nd: .7u/kg
3rd: .8u/kg
Frequency of monitoring inpatient for A1GDM
Fasting, PP until delivery, Twice a day after delivery
metformin, insulin
Barring significant risk factors, the ideal gestational age to screen for gestational diabetes
24-28 weeks
When on CGM, the TIR (time in range) target for someone with preexisting diabetes in pregnancy
70% or more
Typical percentage increase for someone with type 1 diabetes
10%
Frequency of BG monitoring inpatient for A2s, T2s
Fasting, Before and After Each Meal
PP Follow up recommended for A1 or A2 GDM
6-12w OGTT, Yearly PCP visit
2 reasons a patient would not qualify to take a 1 hour or 3 hour GTT
1) They already have a diagnosis of diabetes
2) Hx of gastric bypass/sleeve/etc
When on CGM the TBR (time below range) target
<5%
Typical percentage increase for someone with A2 or T2
15-30%
Fasting 95-105 = 15%
Fasting 105-115 = 20%
Fasting 115-125 = 30%
Frequency of BG monitoring for T1s
q2
Name 3 benefits of benefits of breastfeeding to women with a history of diabetes
1. Improved glycemic control
2. Reduced risk of diabetes/htn long-term
3. Reduced risk of breast cancer