PRE-GESTATIONAL CONDITIONS- MANAGEMENT OF DIABETES MELLITUS

SAS#2: CARE OF THE HIGH-RISK PREGNANT CLIENT

80-120 mg/dL

Normal Blood sugar range

A sign of Hypoglycemia

Sweating with cold, clammy skin

A sign of Hypoglycemia

Pallor

A sign of Hypoglycemia

Tremors, shakiness

A sign of Hypoglycemia

Hunger and nausea

A sign of Hypoglycemia

Irritability or impatience, anger

A sign of Hypoglycemia

Confusion, indicating delirium

A sign of Hypoglycemia

Tachycardia

A sign of Hypoglycemia

Nervousness, anxiety

A sign of Hypoglycemia

Sleepiness

A sign of Hypoglycemia

Blurred vision

A sign of Hypoglycemia

Seizures

A sign of Hypoglycemia

Unconsciousness

A sign of Hyperglycemia

Glycosuria – blood glucose >150 mg/dL

A sign of Hyperglycemia

Polyuria

A sign of Hyperglycemia

Polydipsia

A sign of Hyperglycemia

Polyphagia

A sign of Hyperglycemia

Weight loss: CHON and fat stores are used for energy

A sign of Hyperglycemia

Ketoacidosis

26-28 wks

The period high-risk women should apply for SCREENING TEST

50g oral glucose challenge

The screening test most commonly used for gestational diabetes mellitus (GDM).If abnormal, it is followed by a confirmatory test.

<140 mg/dL at 1 hr

Normal result for 50g oral glucose challenge

≥140 mg/dL at 1 hr

Abnormal result for 50g oral glucose challenge?

100‑gram Oral Glucose Tolerance Test (OGTT)

The diagnostic test used to confirm gestational diabetes mellitus (GDM) after an abnormal screening result (like the 50‑g glucose challenge)?

95 mg/dL after fasting (8-14hrs)

Normal FBS result for 100‑gram Oral Glucose Tolerance Test (OGTT)?

180 mg/dL

Normal result for 100‑gram Oral Glucose Tolerance Test (OGTT) after 1hr?

155 mg/dL

Normal result for 100‑gram Oral Glucose Tolerance Test (OGTT) after 2hrs?

140 mg/dL

Normal result for 100‑gram Oral Glucose Tolerance Test (OGTT) after 3hrs?

1800 - 2200 cal/day

Recommended Diet: cal/day

6%

Normal Hba1c

7%

Abnormal Hba1c

Split-dose insulin regimen

Uses a combination of regular insulin and intermediate-acting insulin, where the total daily insulin dose is divided into two injections

2/3 of the total daily dose given before breakfast at 2:1 ratio (intermediate to regular)

Split-dose insulin regimen: Morning insulin dose

1/3 of the total daily dose given 30 minutes before dinner at 1:1 ratio (intermediate to regular)

Split-dose insulin regimen: Evening insulin dose

15–17 weeks

Fetal Well-being Monitor for Alphafetoprotein level

18-20 weeks and monthly

Fetal Well-being Monitor for Ultrasound

Fetal Well-being Monitor for NST

starting at 34 wks

wk 28 (N=10/hr)

Fetal Well-being Monitor for Daily kick counts? provide normal number of fetal kicks per hour?

34-36 weeks

(N=2.5-3:1)

Fetal Well-being Monitor for Lecithin/sphingomyelin (L/S) ratio?