-CCS......Gestational Diabetes- - pindi
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-CCS......Gestational Diabetes- - pindi
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10-23-2008, 10:51 PM
26 weeks pregnant female had a glucose value of 175mg/dL, after one hour GTT.
previous baby was 4200gm. ...her fundal height is 32 cms. what next....
10-23-2008, 10:58 PM
do 3 hr glucose tolerance test
if fasting>95 or 1 hr level >180, 2 hr >155 , 3 hr >140-->suggests Gestational DM educate Diet HB1ac lipid profile foot care BP check USG abd EKG UA CBC BMP home glucose monitoring send home call after a month glucose is still high start Insulin sub cu medication compliance medication side effect
10-23-2008, 11:01 PM
do 3 hr glucose tolerance test
if fasting>95 or 1 hr level >180, 2 hr >155 , 3 hr >140-->suggests Gestational DM DO Nst first and if abnormal then do bpp.. USG abd bcoz fundal height is not acc to gestational weeks educate Diet HB1ac lipid profile foot care BP check USG abd EKG UA CBC BMP home glucose monitoring send home call after a month glucose is still high start Insulin sub cu medication compliance medication side effect
10-23-2008, 11:02 PM
just added something in dr jayhind!!!
corrct me if wrong!!!
10-23-2008, 11:04 PM
3 Hr gtt values > 80 1 hr,>155 2 hr,> 140 3 hr_----
diet,education, urine r/e cbc bmp hba1c home glu monitoring eye check up start insulin. send home only all the tests r within acceptable range. follow up after 1 wk if no more new s/s.
10-23-2008, 11:04 PM
key point here...
one hour GTT is giving high glucose level.. next step is ....3 hr GTT.... HPL antagonizes insulin...HPL only increases after 26 weeks. so any women who has a high BS before 26 wks is diabetic...
10-23-2008, 11:06 PM
Hba1c will tell us if she is a diabetic or a case of GDM. Elevated Hba1c will indicate a case of Preconceptional elevated blood glucose and DM.
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