Gestational & Pregestational Diabetes Management Flashcards
7 cards from real BC ADM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Gestational & Pregestational Diabetes Management flashcards as text
A woman with pregestational type 1 diabetes is planning pregnancy. Which HbA1c target is recommended prior to conception to minimize congenital anomaly risk?
Answer: Less than 6.5% (48 mmol/mol)
Preconception HbA1c <6.5% is recommended to minimize the risk of congenital malformations, as anomalies primarily develop in the first trimester.
Which maternal complication is most strongly associated with uncontrolled pregestational diabetes during the first trimester?
Answer: Congenital anomalies
Congenital anomalies are most strongly linked to hyperglycemia during organogenesis in the first trimester, when pregestational diabetes is established.
A patient with GDM at 34 weeks has a nonstress test showing repetitive late decelerations. The most appropriate next step is:
Answer: Proceed to delivery or further evaluation with biophysical profile
Repetitive late decelerations indicate uteroplacental insufficiency and require urgent further evaluation (BPP) or delivery rather than watchful waiting.
Diabetic ketoacidosis (DKA) in pregnancy is most dangerous because it can occur at a blood glucose level as low as:
Answer: 180 mg/dL
Pregnancy lowers the threshold for DKA; euglycemic DKA can occur at glucose levels as low as 180 mg/dL due to altered metabolism and increased ketogenesis.
When counseling a woman with GDM about breastfeeding, which benefit should be emphasized?
Answer: Breastfeeding is associated with reduced risk of type 2 diabetes in the mother and offspring
Breastfeeding is associated with lower long-term risk of type 2 diabetes for both the mother who had GDM and her child.
A woman with pregestational type 2 diabetes is switched from oral agents to insulin at conception. Which oral agent is sometimes continued or used in pregnancy as an alternative to insulin?
Answer: Metformin
Metformin is sometimes continued or used in pregnancy for type 2 diabetes, though it crosses the placenta; evidence of safety is growing but insulin remains the standard of care.
In a neonate born to a mother with poorly controlled diabetes, which metabolic complication should be anticipated and monitored for in the first hours after birth?
Answer: Neonatal hypoglycemia
Neonatal hypoglycemia occurs because fetal hyperinsulinism persists after birth once the maternal glucose supply is cut off at delivery.