GDM

What is the definition of Gestational Diabetes Mellitus (GDM)?

Diabetes Mellitus developing at or beyond 24-28 weeks of pregnancy, identified using a 75g Oral Glucose Tolerance Test (OGTT).

What percentage of pregnancies are affected by gestational diabetes worldwide?

Approximately 7% of all pregnancies are complicated by gestational diabetes mellitus.

What are the common maternal effects of diabetes in pregnancy?

Diabetic ketoacidosis (DKA), nephropathy, retinopathy, and increased susceptibility to infections.

What is the recommended preprandial glucose level for pregnant women with gestational diabetes (GDM)?

Less than 95 mg/dL (5.3 mmol/L).

What major dietary components are recommended for women with gestational diabetes?

A minimum of 175 grams of carbohydrates distributed across three small to moderate meals and 2-4 snacks.

What are the risks associated with poorly controlled diabetes during pregnancy?

Increased perinatal morbidity and mortality, which may necessitate earlier delivery.

What fetal effects can result from gestational diabetes mellitus?

Spontaneous abortion, preterm delivery, congenital malformations, altered fetal growth, and unexplained fetal demise.

What is the recommended level of glycosylated hemoglobin (HbA1c) for optimal outcomes in preconception care for diabetic patients?

Less than 6.9% to minimize the risk of malformation.

What is the significance of Human Chorionic Somatomammotropin in pregnancy related to diabetes?

It has a strong lipolytic effect and anti-insulin action, which can increase maternal glucose levels and free fatty acids.

What is the management approach for women with gestational diabetes during labor?

Use only short-acting insulin via IV infusion for plasma glucose levels above 120 mg/dL.

How often should women on insulin monitor their capillary blood glucose levels?

4-6 times a day.

What are some common high-risk factors for developing GDM?

Unexplained intrauterine fetal demise (IUFD), maternal obesity, family history of diabetes, and advancing maternal age.

When should a 75g OGTT be performed for prospective GDM patients?

Between 24-28 weeks of gestation.

What is the ideal dietary fat composition recommended for managing gestational diabetes?

It should consist of 25% fat, of which less than 10% is saturated fat.

What insulin dosage protocol is recommended during the third trimester?

1.2 U/kg of actual body weight.

What is the recommendation for monitoring glucose levels in the immediate postpartum period?

Monitor every 4-6 hours for 24 hours and administer insulin when indicated.

What is the impact of placenta-derived hormones on insulin sensitivity during pregnancy?

They cause decreased tissue sensitivity to insulin, contributing to greater maternal hyperglycemia.

What dietary approach may protect against cesarean sections in women with GDM?

Following a DASH diet rich in fruits, vegetables, whole grains, and low-fat dairy.

What factors should be assessed to determine the timing of delivery in pregnancies complicated by DM?

Extent of glycemic control, presence of hydramnios, pregnancy comorbidities, and estimated fetal weight.