Endocrinology & Diabetes — Flashcards

Flashcard 641: Management of pregnant women with pre-existing diabetes mellitus involves _____ and commencing insulin.

Answer: stopping oral hypoglycaemic agents (except Metformin)

Extra: Pre-existing diabetes (Type 1 or Type 2) requires strict glycaemic control to prevent congenital malformations and macrosomia. Most oral agents are discontinued in favor of insulin due to better titration and safety data. Metformin is the primary exception often continued.

Flashcard 642: Weight loss for pregnant women with pre-existing diabetes is _____ regardless of BMI.

Answer: not recommended

Flashcard 643: How should gestational diabetes be treated if fasting plasma glucose < 7 mmol/L and glucose targets are not met after 1-2 weeks of diet and exercise trial? _____

Answer: Add metformin, then insulin if glucose targets are still not met

Flashcard 644: How would you screen for gestational diabetes in a pregnant woman who have had gestational diabetes in a previous pregnancy? _____

Answer: OGTT as soon as possible after booking, and again at 24-28 weeks

Flashcard 645: Diagnostic thresholds for gestational diabetes are 2-hour glucose ≥ _____

Answer: 7.8 mmol/L

Flashcard 646: Gestational _____ is the second most common gestational disorder

Answer: diabetes

Flashcard 647: Diagnostic thresholds for gestational diabetes are fasting blood glucose ≥ _____

Answer: 5.6 mmol/L

Flashcard 648: Women with any risk factors for gestational diabetes should be offered an _____

Answer: OGTT at 24-28 weeks

Flashcard 649: How should gestational diabetes be treated if fasting plasma glucose ≥ 7 mmol/L? _____

Answer: Insulin ± metformin

Flashcard 650: How should gestational diabetes be treated if fasting plasma glucose < 7 mmol/L? (step by step - 3) _____

Answer: Diet & exercise trial 1-2 weeks → add metformin → add insulin