Diabetes in Pregnancy

1. Pre-gestational Diabetes is classified as a carbohydrate intolerance diagnosed prior to pregnancy.

a) True
b) False

2. Gestational Diabetes is classified as a carbohydrate intolerance that occurs with the onset of pregnancy or is first recognized during pregnancy (FBS > 126 mg/dl, Hbg A1c > 6.5%, or Random Glucose > 200).

a) True
b) False

3. Management of pre-gestational diabetes and insulin requiring gestational diabetes is more intensive because of increased risk to the fetus.

a) True
b) False

4. Approximately 90% of patients with gestational diabetes are non-insulin requiring.

a) True
b) False

5. Which of the following are therapy options to consider in initiating care to begin managing gestational diabetes:

a) Medical Nutrition Therapy (MNT): 50 – 90% can be managed with MNT, limit carbohydrates to 35 – 45% of total caloric intake, utilize complex carbohydrates, culturally appropriate food choices
b) Exercise: lowers fasting and postprandial glucose levels, aerobic, 30minutes, 5x/week
c) Home glucose monitoring
d) All of the above

6. Metformin and Glyburide are oral agents that are used for glucose management, but are not FDA approved for use in pregnancy. Both drugs are endorsed by ACOG and ADA with cautions.

a) True
b) False

7. With insulin and/or non-insulin pharmacologic treatment of diabetes in pregnancy, the goal is euglycemia and home monitoring is essential (FBS < 95 mg/dL, 1 hour pp < 130-140 mg/dL, 2 hours post prandial < 120 mg/dL).

a) True
b) False