Gestational Diabetes Mellitus


Step 1: View clinicals

A 29 year old primigravida of South Asian origin, in her 24th week of pregnancy, is referred for further management after her 50g 1 hour glucose challenge test result was found to be 146 mg/dL. The same test performed at 6 weeks gave a result of 124 mg/dL. Her medical history is unremarkable, but her family history is positive for type 2 diabetes in both parents.

Step 2: Order all relevant investigations


Her HbA1c level is 6.3%

100g 3hr OGTT

At 0-hours: 101 mg/dL (normal: <95) At 1 hour: 190 mg/dL (normal: <180) At 2 hours: 157 mg/dL (normal: <155) At 3 hours: 140 mg/dL (normal: <140)

Urine Dipstick for Glucose

The dipstick test is positive for glucosuria

Urine protein test

Trace amounts of protein are noted

Step 3: Select appropriate management

Insulin stat
ACE Inhibitors
Monitor Blood Pressure
Deliver at 38 weeks

Score: ★★☆