Chapter 20

Material Diabetes Case Study

Answers

1. B – Macrosomia. Poorly controlled maternal diabetes increases fetal glucose levels, leading to excessive fetal insulin production and overgrowth (macrosomia), which can cause complications during delivery.
2. B – “Insulin will help control your blood sugar more effectively since your levels are still high.” While some oral antidiabetics like metformin are considered safe in pregnancy, insulin is often required for better glucose control when blood sugar remains elevated, as in Mrs. Taylor’s case.
3. C – Teaching her how to monitor her blood glucose levels regularly and adjust diet accordingly. Self-monitoring of blood glucose is essential for identifying trends and making appropriate dietary and medication adjustments to maintain stable blood sugar levels.
4. A – Preeclampsia. Poorly controlled diabetes increases the risk of preeclampsia, a serious pregnancy complication characterized by high blood pressure and signs of organ damage.
5. A – To ensure the baby does not experience hypoglycemia after birth. If maternal glucose levels are high during labor, the baby produces excessive insulin in utero, increasing the risk of neonatal hypoglycemia after birth when the maternal glucose supply is cut off.
6. B – “You may need less insulin now, but you should continue monitoring your blood sugar closely.” Insulin requirements often decrease postpartum, but continued glucose monitoring is important to adjust therapy and reduce the long-term risk of complications.

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