Obgyn 9 Dm In Preg

Front 1

1. Pathophys of Gestational Diabetes?

Back 1

a. Human chorionic somatomammotropin (aka human placental lactogen) and hormones produced by the placenta act as anti-insulin agents leading to increased insulin resistance and generalized carbohydrate intolerance.
b. Bc these hormones increase in volume w/the size and function of the placenta, the carb metabolism abnormalities usually are not apparent until the late second Trimester or early third trimester.

Front 2

2. Key difference with gestational Diabetes vs. progestational DM?

Back 2

a. Bc gestational DM doesn’t occur until the late 2nd or early third Tri-M, they are not at increased risk of congenital anomalies like women w/progestational DM.
b. They do, however, have ↑’d risk of fetal macrosomia and birth injuries as well as neonatal hypoglycemia, hypocalcemia, hyperbilirubinemia, and polycythemia like those w/progestational DM.

Front 3

3. Best time to screen for diabetes during pregnancy?

Back 3

a. End of 2nd Tri-M between 24-28 wks in women w/low risk for GDM.
b. Pts w/1 or more risk factors should be screened at first prenatal visit.

Front 4

4. Tx of all pts w/DM during pregnancy?

Back 4

a. ADA Diet of 2200 calories/day with 200-220 g of CHO/day.

Front 5

5. Classification system used for gestational DM?

Back 5

a. White’s classification.
b. A1= diet controlled Gestational diabetes.

Front 6

6. A2 Gestational DM?

Back 6

a. Medication-controlled.