Gestational Diabetes Lecture Notes

Introduction

• Presenter: Sarah from RegisteredNurseRN.com
• Topic: Gestational Diabetes
• Free quiz available after watching

What is Gestational Diabetes?

• A form of diabetes that occurs during pregnancy
• Typically arises in the second or third trimester

Risk Factors (Mnemonic: MAMA)

• M: Maternal age over 25 years
• O: Overweight or Obese (BMI > 25 for overweight, > 30 for obese)
• M: Macrosomia (previous baby > 9 pounds)
• M: Multiple pregnancies
• A: History of gestational diabetes or family history of diabetes

Pathophysiology

Key Players

1. Pregnancy Hormones: Affect insulin sensitivity
2. Mom's Metabolic System: Decreased insulin sensitivity
3. Baby's Growth: Nutrient demands change

Insulin and Diabetes Overview

• Insulin: Produced by pancreas beta cells; helps cells uptake glucose
• Type 1 Diabetes: Autoimmune destruction of beta cells
• Type 2 Diabetes: Insulin resistance
• Gestational Diabetes: Insulin resistance during pregnancy, similar to Type 2

Potential Outcomes

• Gestational diabetes often resolves after birth
• 50% risk of developing Type 2 diabetes later

Insulin Sensitivity Changes During Pregnancy

• Early Pregnancy: High insulin sensitivity for growth
• Later Pregnancy: Placental hormones (human placental lactogen, estrogen, cortisol, progesterone) decrease insulin sensitivity

Effects of Gestational Diabetes

• Mom: Risk of hyperglycemia, urinary tract infections, yeast infections, hypertension, preeclampsia, C-section
• Baby: Macrosomia, risk of hypoglycemia at birth, respiratory distress

Signs and Symptoms (Mnemonic: Three P's)

• Polyphagia: Excessive hunger
• Polydipsia: Excessive thirst
• Polyuria: Excessive urination
• Sugar in Urine
• Fruity breath, dry mouth, infections

Nurse's Role (Mnemonic: SUGAR BABE)

• S: Screening
  • 24-28 weeks gestation
  • 1-hour oral glucose tolerance test (OGTT)
• U: Use Diet and Exercise
  • Manage blood glucose
  • Insulin or oral meds if needed
• G: Glucose Monitoring
  • Fasting: 70-95 mg/dL
  • Post-meal: <140 mg/dL
• A: Assess Urine for glucose
  • Check for UTIs
• R: Risk Factors
  • Assess at prenatal visits
• B: Blood Glucose Swings during and after labor
  • Monitor levels closely, use insulin or glucose as needed
• A: Adverse Effects
  • Watch for preeclampsia, infections, respiratory distress in baby
• B: Blood Glucose Monitoring Postpartum
  • 6-12 weeks postpartum
• E: Educate
  • Importance of regular diabetic testing due to risk of Type 2 diabetes

Conclusion

• Regular monitoring and education are crucial for managing gestational diabetes and preventing Type 2 diabetes in the future.