Chapter 11

What is gestational diabetes

Class A Gestational Diabetes
(White's classification)

Class B Gestational Diabetes
(White's classification)

Glucose crosses the placenta?
(T/F)

Insulin crosses the placenta?
T/F

Around the_____ week of gestation the fetus begins to produce its own _______

During the 1st trimester, metabolic changes occur, caused by rising levels of estrogen and progesterone. These hormones stimulate the production of insulin, causing fasting glucose levels to fall by approximately ________?

As a result of normal metabolic changes. Pregnant women with _________ diabetes, are prone to ______ during the first trimester.

During the first trimester insulin needs ______

During the second trimester insulin needs ______

During the third trimester insulin needs ______

Insulin needs usually level off after _____ weeks of gestation

Day of birth: insulin needs _____

Insulin needs of a non-breastfeeding mother are ______

The insulin needs of a breast feeding mother generally return to normal after _______

Breastfeeding causes a _____ in insulin needs

Target blood glucose during pregnancy
Fasting

Target blood glucose during pregnancy
1 hr postmeal

Target blood glucose during pregnancy
2 hr postmeal

Target blood glucose during pregnancy
2 am to 6 am

When is hyperglycemia most likely to be identified in relation to meals, and why?

Signs and symptoms
hypoglycemia

No increase in risk of birth defects has been found among infants of woman who develop GDM after the first trimester.
Why?

A BMI of _____ also contributes to the development of congenital defects even without GDM

Care management for GDM includes:

Indicators that warrant early GDM screening include:

Screening for GDM consists of a 50g glucose load followed by a plasma glucose test 1 hr later. Fasting not required. What is considered a positive result?

In cases of a positive GDM screen, a 2step test is performed. In the 2nd step, a 100g glucose load is delivered and followed with a 3hr oral glucose tolerance test (OGTT)
Positive 3hr results include:

24-28 week screening consists of a
75g OGTT and is considered positive if ....

Antepartum interventions for GDM include

Antepartum blood glucose goals for GDM are

Antepartum dietary goals for GDM arm

Pharmacologic therapy for GDM includes

What is the preferred oral hypoglycemic in GDM patients?

Does metformin cross the placenta?

Fetal surveillance is recommended in which GDM patients

Fetal surveillance consists of

Intrapartum interventions for GDM include

Intrapartum blood glucose goals are

Is GDM an indicator for cesarean birth?

What are some postpartum risks for GDM patients?

Most women's blood glucose_____________after birth involving GDM

What is macrosomia