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22 Cards in this Set
- Front
- Back
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Which patients are at high risk of gestational diabetes?
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History of GDM
Large babies in past Family history PCOS |
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When should high risk patients be screened for GDM?
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At first prenatal visit
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Definition of gestational diabetes
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Pregnant women who have never had diabetes before but who have high blood glucose levels during pregnant
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Ethnic groups with high GDM
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Latino
African American Native American South Asian East Asian Pacific Islander |
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What study paved the way for new diagnostic criteria for GDM?
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HAPO Study
The Hyperglycemia and Adverse Pregnancy Outcome Study |
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When should pregnant women not at high risk be screened for GDM?
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24 to 28 weeks gestation
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How is GDM screened for using the OGTT
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75 gram OGTT in the morning following an overnight fast of at least 8 hours. Measure plasma glucose at fasting and after 1 and 2 hours.
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Diagnostic criteria for GDM
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Fasting > 92 mg/dl
1 hour > 180 mg/dl 2 hour > 153 mg.dl **Any single lab value above the criteria is considered diagnostic |
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What are the normal glucose values in pregnancy
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Fasting: 60 to 90 mg/dl
1 hour post prandial: <120 mg/dl |
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What is the initial treatment for GDM
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Medical nutrition therapy
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What exercise regimen is recommended as part of medical nutrition therapy?
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Walk 20 to 30 minutes daily
Walk for 10 minutes after each meal |
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When does insulin resistance peak in GDM?
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3rd trimester
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What pregnancy category is metformin?
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B
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How does metformin compare to insulin according to the Metformin in Gestational Diabetes Trial?
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No difference at different levels of glucose control
No serious adverse events No difference in perinatal complications Women prefer metformin |
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What pregnancy category is glyburide?
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B or C (depending on manufacturer)
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What drug class is considered the standard of care in GDM?
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Insulin
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How should fasting hyperglycemia be corrected in GDM?
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0.2 units/kg of NPH at bedtime
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How should postprandial hyperglycemia be corrected in GDM?
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1.5 units/10 grams of carbs lispro/aspart before breakfast
1 unit/10 grams of carbs lispro/aspart before lunch and dinner |
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How should fasting and postprandial hyperglycemia be corrected in GDM?
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0.6 to 0.9 units/kg daily using NPH and aspart or lispro
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Is human insulin or analog insulin better in GDM?
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Neither, there is no significant difference in occurrence of adverse fetal outcomes
*Study focused on glargine |
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When should patients with GDM be screened for diabetes postgestation?
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6 to 12 weeks postpartum and at least once every 3 years
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What is the AIC goal for women prior to conception?
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AIC < 7 or as close to normal as possible
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