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30 Cards in this Set
- Front
- Back
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% of pregnancies that are affected by abnormal glycemic control
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3-10%
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Pederson hypothesis
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maternal hyperglycemia results in fetal hyperglycemia
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at what point in pregnancy does the fetal pancreas start to produce insulin?
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20 weeks gestation
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pathology associated w/ maternal diabetes early in the pregnancy is related to ___
late in the pregnancy it is related to ___ or ____ |
hyperglycemia
hyperglycemia or hyperinsulinemia |
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50% of the congenital anomalies seen in IDM affect the ___ and the ___
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brain and the heart
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abnormal development of the lower spine associated w/ IDM
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Caudal Regression Syndrome
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mechanism for macrosomia in IDM
how is it possible for fetal hypoglycemia to occur in this scenario? |
elevated mother's glucose -> elevated fetal glucose -> elevated fetal insulin -> increased fat stores
if mother's glucose rapidly decreases, and insulin levels have been chronically stimulated, fetal hypoglycemia results |
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fetal oxygen demands in IDM
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increased by as much as 30% due to increased metabolic demands
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major cardiac complication of IDM
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septal deposition of glycogen stores
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growth development abnormality in IDM
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macrosomia (35%)
weight percentile relatively high compared to length/head circumference |
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____ is an excellent indication of infants more likely to have neonatal morbidity
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macrosomia at birth
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point during delivery process when hypoglycemia becomes an issue
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when the cord is clamped
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the lowest point of blood glucose in the neonate is at ___
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1-3 hours of age
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the currently accepted definition of hypoglycemia in the neonate
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50 mg %
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primary treatment should focus on ___
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maternal glucose control during pregnancy
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of insulin and glucose, the one that crosses the placenta
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glucose
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typical symptoms of neonatal hypoglycemia
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jitteriness
sweating apnea respiratory distress agitation lethargy/poor feeding seizures |
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when do hypocalcemia and hypomagnesemia occur?
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w/in 72 hours of birth
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deficiencies of two electrolytes that produce hypoglycemic-like symptoms between 24 and 72 hours after birth
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hypocalcemia and hypomagnesemia
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treatment for hypocalcemia and/or hypomagnesemia
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**referral to NICU**
IV (Ca and Mg) close cardiac monitoring |
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characteristics of the polycythemic infant
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sluggish
plethoric lethargic (poor eater) |
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symptomatic, polycythemic infant is ___ until proven otherwise
treatment? |
venous sinus thrombosis
partial exchange transfusion |
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treatment for polycythemia is based on ___
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clinical symptoms, not absolute lab values
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iron-deficient infants are at increased risk for ____
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neurodevelopment and neurobehavioral abnormalities
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pulmonary syndrome that hyperglycemic neonates are at increased risk for
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respiratory distress syndrome
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treatment for cardiac function abnormalities in IDM
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B-blockers and time
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a heterogeneous condition in which the clinical manifestation of hyperglycemia is a reflection of impaired balance between insulin sensitivity and insulin secretion
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type II diabetes in youth
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lifetime risk of diabetes w/ a first degree relative with type II diabetes
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40%
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diffuse hyperplasia of the spinous layer of the skin that manifests as a velvety, hyperkeratotic darkening of the skin
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acanthosis nigracans
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general manifestations of IDM in the newborn
(outline slide) |
growth abnormalities
increased oxygen demand cardiac abnormalities hyper/hypoglycemia hypocalcemia/hypomagnesemia iron deficiency jaundice respiratory destress syndrome CNS effects |
