DIABETES IN PREGNANCY COPY | GUARANTEED SUCCESS
STARTS HERE! LEARN, PRACTICE & EXCEL!
A1GDM Answer: - diet controlled GDM
A2GDM Answer: - requires medications
- Approximately 25-50% of individuals with GDM require treatment with medications despite
compliance with diet and exercise
Gestational diabetes definition Answer: - carbohydrate intolerance of varying degrees
- onset or first recognition during pregnancy
Medications for GDM Answer: - insulin first line
- metformin or glyburide
- indicated if > 30% of glucose values in one week are above the target thresholds (fasting- 95
mg/dL and 1-hr postprandial 140 mg/dL)
Risk factors for GDM Answer: - Overweight/obesity
- Lack of physical activity
- Previous GDM, pre-diabetes
- PCOS
- Diabetes in 1st degree relatives
- Previous delivery of a > 9lb baby or baby with malformations
- Black, Latino, NativeAmerican, Asian, Pacific Islander
- Older age (especially >40years)
Pre-existing type 1 or type 2 DM management during pregnancy Answer: - no glucose screening
needed
- critical to maintain tight blood sugar control, adjust meds prn
- monitor HgB A1C levels (Hgb A1C of > 6.5% associated with higher risk of congenital
anomalies)
Screening and testing for DDM Answer: - universal screening between 24- 28 weeks
- early screening (at initiation of prenatal care) for patients with risk factors
APPHIA – Crafted with Care and Precision for Academic Excellence.
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, - if early screening is negative, repeat at 24-48 weeks
Qualifications for early screening for GDM Answer: Patients with a BMI > 25 (23 in Asian
individuals) and 1 or more of the following:
- Previous GDM, macrosomia, unexplained stillbirth, baby with malformations
- Physical inactivity
- 1st degree relative with diabetes
- High-risk race or ethnicity (Black, Latino, American Indian, Asian, PacificIslander)
- HTN, h/o CVD
- Low HDL or high triglycerides
- PCOS, acanthosis nigricans, morbid obesity and other conditions associated with insulin
resistance
- A1C greater than 5.7% on previous testing, impaired glucose tolerance or impaired fasting
glucose
Methods to screen/test for GDM Answer: - Screening (2-step method, recommended by ACOG)
OR
- Diagnostic (1-step method)
Screening (2 step method) Answer: - screen: drink 50g oral glucose drink in five minutes, test
blood 1 hour later ---> positive screen blood glucose >130-140mg/dL
- don't have to fast
- if positive, proceed to diagnostic testing with 3-hour 100g GTT
50g GCT ≥ 200 Answer: - patient is diagnosed with GDM (likely pre-existing);no further testing
needed
Positive screening blood glucose (2-step method) Answer: > 130 to 140 mg/dL
Diagnostic (1-step method) Answer: - 2-hour 75 g GTT
- only 1 abnormal value is needed for GDM diagnosis
3-hour glucose tolerance test (3-hr GTT) Answer: - fasting for 8-12 hours beforehand
1.) check fasting
2.) give 100- gram glucose drink
3.) glucose levels drawn every hour
APPHIA – Crafted with Care and Precision for Academic Excellence.
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STARTS HERE! LEARN, PRACTICE & EXCEL!
A1GDM Answer: - diet controlled GDM
A2GDM Answer: - requires medications
- Approximately 25-50% of individuals with GDM require treatment with medications despite
compliance with diet and exercise
Gestational diabetes definition Answer: - carbohydrate intolerance of varying degrees
- onset or first recognition during pregnancy
Medications for GDM Answer: - insulin first line
- metformin or glyburide
- indicated if > 30% of glucose values in one week are above the target thresholds (fasting- 95
mg/dL and 1-hr postprandial 140 mg/dL)
Risk factors for GDM Answer: - Overweight/obesity
- Lack of physical activity
- Previous GDM, pre-diabetes
- PCOS
- Diabetes in 1st degree relatives
- Previous delivery of a > 9lb baby or baby with malformations
- Black, Latino, NativeAmerican, Asian, Pacific Islander
- Older age (especially >40years)
Pre-existing type 1 or type 2 DM management during pregnancy Answer: - no glucose screening
needed
- critical to maintain tight blood sugar control, adjust meds prn
- monitor HgB A1C levels (Hgb A1C of > 6.5% associated with higher risk of congenital
anomalies)
Screening and testing for DDM Answer: - universal screening between 24- 28 weeks
- early screening (at initiation of prenatal care) for patients with risk factors
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, - if early screening is negative, repeat at 24-48 weeks
Qualifications for early screening for GDM Answer: Patients with a BMI > 25 (23 in Asian
individuals) and 1 or more of the following:
- Previous GDM, macrosomia, unexplained stillbirth, baby with malformations
- Physical inactivity
- 1st degree relative with diabetes
- High-risk race or ethnicity (Black, Latino, American Indian, Asian, PacificIslander)
- HTN, h/o CVD
- Low HDL or high triglycerides
- PCOS, acanthosis nigricans, morbid obesity and other conditions associated with insulin
resistance
- A1C greater than 5.7% on previous testing, impaired glucose tolerance or impaired fasting
glucose
Methods to screen/test for GDM Answer: - Screening (2-step method, recommended by ACOG)
OR
- Diagnostic (1-step method)
Screening (2 step method) Answer: - screen: drink 50g oral glucose drink in five minutes, test
blood 1 hour later ---> positive screen blood glucose >130-140mg/dL
- don't have to fast
- if positive, proceed to diagnostic testing with 3-hour 100g GTT
50g GCT ≥ 200 Answer: - patient is diagnosed with GDM (likely pre-existing);no further testing
needed
Positive screening blood glucose (2-step method) Answer: > 130 to 140 mg/dL
Diagnostic (1-step method) Answer: - 2-hour 75 g GTT
- only 1 abnormal value is needed for GDM diagnosis
3-hour glucose tolerance test (3-hr GTT) Answer: - fasting for 8-12 hours beforehand
1.) check fasting
2.) give 100- gram glucose drink
3.) glucose levels drawn every hour
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
