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.


Step 2: Order Relevant Investigations

1. Urine dipstick for glucose

clear

The dipstick test is positive for glucosuria.

2. 100g 3hr OGTT

check

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

check

Her HbA1c level is 6.3%

4. Urine protein test

check

Trace amounts of protein are noted.

Step 3: Select Appropriate Management

1. Insulin stat

clear

2. ACE inhibitors

clear

3. Monitor blood pressure

check

4. Deliver at 38 weeks

check