Lecture Notes on Gestational Diabetes Mellitus

Introduction

• Presenter: Meris
• Topic: Gestational Diabetes Mellitus (GDM)
• Importance: Key for maternity courses due to patient teaching and impacts on the baby.
• Materials: Maternity flashcards available at leveluprn.com

What is Gestational Diabetes?

• Definition: Diabetes during pregnancy in someone previously non-diabetic.
• Condition: Impaired glucose tolerance during pregnancy.

Risk Factors

• Obesity
• Prior gestational diabetes
• Strong family history of diabetes/GDM
• Hypertension

Signs and Symptoms

• Often asymptomatic
• Similar to regular diabetes: polyuria and polydipsia
• Pregnancy causes frequent urination, making it hard to distinguish.

Screening and Diagnosis

• Screening Test: Oral Glucose Tolerance Test (OGTT)
  • Initial Test: 1-hour test
  • If failed: 3-hour test for diagnosis

Treatment

• Lifestyle Modifications:
  • Increase exercise
  • Dietary changes to reduce carbs
  • Blood glucose monitoring
• Medication:
  • Insulin may be required (oral diabetic medications often contraindicated during pregnancy)
  • Not all patients require insulin

Complications

• Fetal Macrosomia: Large body size in newborn
• Neonatal Hypoglycemia: Post-birth blood sugar crash
  • Baby receives high sugar from mom, post-birth sugar source cut off.
• Other Risks:
  • Pre-eclampsia
  • Birth trauma & C-section due to large baby
  • Postpartum diabetes screening required

Hypoglycemia vs. Hyperglycemia in GDM

Hypoglycemia

• Definition: Low blood sugar
• Symptoms:
  • Diaphoresis (sweating)
  • Cold, clammy skin
  • Headache, shakiness, blurred vision
  • Hunger
• Mnemonic: "Cold and clammy, I need candy."
• Treatment:
  • 15g of quickly absorbed glucose (juice, soda, milk)
  • Followed by a protein snack

Hyperglycemia

• Definition: High blood sugar
• Symptoms:
  • Polydipsia (thirst), Polyphagia (hunger), Polyuria (urination)
  • Warm, dry skin
  • Fruity breath odor
  • Rapid breathing (Kussmaul's respirations)
  • Fatigue
• Mnemonic: "If my skin is warm and dry, my sugar's high."

Conclusion

• Importance of recognizing signs and managing GDM effectively.
• Encouragement to engage with educational content and share learning experiences.