New
Endocrine System
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.
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 Relevant Investigations
1. Urine dipstick for glucose
The dipstick test is positive for glucosuria.
2. 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)
3. HbA1c
Her HbA1c level is 6.3%
4. Urine protein test
Trace amounts of protein are noted.
1. Urine dipstick for glucose
The dipstick test is positive for glucosuria.
2. 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)
3. HbA1c
Her HbA1c level is 6.3%
4. Urine protein test
Trace amounts of protein are noted.
Step 3: Select Appropriate Management
1. Insulin stat
2. ACE inhibitors
3. Monitor blood pressure
4. Deliver at 38 weeks
1. Insulin stat
2. ACE inhibitors
3. Monitor blood pressure
4. Deliver at 38 weeks