Table Of Contents
DM Treatment thru Pregnancy
- DM before pregnancy:
- – A1C <7%
- – Diet and excerize then meds
- – Change orals –> Insulin
- During pregnancy
- – Increased insulin demand
- -Basal bolus
- – Post-prandial sugar log
- Post Pregnancy
- – Decreased insulin demand
- – Same day or next day decreased insulin
- Uncontrolled sugar can cause
- – Macrosomia
- – Transposition of the great vessels
Gestational DM
- Path:
- DM > 20 weeks
- Insulin insensitivity
- Preconception obesity
- 1lb/week weight gain
- Advanced maternal age
- Pt: BMI > 30, GDM hx, pre-DM
- Dx:
- 1hr glucose tolerance test (gTT) (50g):
- 3hr gTT (100g): Fasting
- CANNOT use A1c
- Treatment:
- Insulin q HS qAC–> post-prandial
- No orals