Further, Criteria for Diagnosis: all DM types

DM Type I - leads to ketoacidosis because the main 1. Random blood glucose at 200 mg/dL or more +
problem is insulin deficiency classic symptoms (polyuria, polydipsia, polyphagia
and unexplained weight loss)
DM Туре II
- leads OR:

 to Hyperglycemic Hyperosmolar Nonketotic 2. FBS 126 mg/dL or more + classic symptoms.

Syndrome because there is still insulin to
inhibit fat breakdown (Ketosis) so there is  Oral Glucose Tolerance Test
no ketoacidosis
 50 - grams glucose tolerance test
Gestational Diabetes  if result is > 140 mg/dL, proceed to 100 -
gram test
PATHOPHYSIOLOGY
 100 grams glucose tolerance test If 2
Placental Hormone Secretion readings are greater than what is given,
/ positive for
(Human Placental Lactogen/ Somatomammotropin)
/  DM (diagnosis is made by the doctor)
HPL Prevents glucose from entering the cells
/  Fasting - 105 mg/dL
Insulin Resistance
/  1 hour - 190 mg/dL
HYPERGLYCEMIA
/
 2 hours - 165 mg/dL
GESTATIONAL DIABETES MELLITUS (Babies)
Gestational Diabetes
 3 hours -145 mg/dL
/
High blood glucose levels in mother
Management - DM Type 1
/
Brings extra glucose to baby  Insulin - primary
/  Modified Nutritional Therapy
Causes baby to put on extra weight  Exercise
/  Glucose monitoring
Macrosomia
Management - DM Type 11
Risk Factors for GDM:
 Insulin Resistance is associated with obesity
 Multiple gestation hence, primary treatment is weight loss
(diet)
 Marked obesity
 Exercise is important in enhancing
 Family history of DM effectiveness of insulin and for weight loss.

 Previous history of GDM  Oral Antidiabetic Agents are given if meal

and exercise are not successful in controlling
 (+) Glycosuria blood glucose levels

Gestational Diabetes

 Women at risk must be screened (OGTT) on

their first prenatal visit and re tested on the
24th - 28th week of gestation.

 At post-partum, blood glucose should go

back to normal. If Hyperglycemia persists,
then the woman has developed DM Type 11.

Diagnostic Exam
 Oral Glucose Tolerance Test
 Glucose Challenge Test
 Others