Question

Nancy is 32 years old living with her partner and has a 3 year-old daughter. She is 16-weeks pregnant with her 2nd child and is having her clinic visit. she is 5'10" weighing 225 lbs. Her obstetrician is concerned about her weight gain (gained 14 lbs in 16 weeks) and advised about her dietary management. He did an A1c test with a result of 6.5%.

1. What are the screening and diagnostic tests for gestational diabetes?

2. What are the specific health teachings for Nancy at this time?

3. What are the potential maternal and fetal complications of diabetes in pregnancy?

Answer 1

1) •Doctor should determine, If Nancy is suffering from symptoms of Gestational diabetes like increase thirst, hunger, dry mouth, fatigue.

•Gestational diabetes mellitus screening should be done by oral glucose tolerance test (OGTT).  

2) Health teaching.

• Avoid sweet, desert like candy, cookies.

• High protein containing food should be taken like egg, fish, chicken.

• cereals, green leafy vegetables, fruits should be taken.

• Insulin should be taken as per doctor's order.

• Blood glucose should be checked before eating in the morning and 2hrs after breakfast and lunch.

• Alcohol , smoking should be avoided.

3.• Maternal complications.

a. Preterm labour.

b. Pre- eclampsia.

c. Increase infective morbidity.

d.excessive accumulation of amniotic fluid.

e. Oligohydramnios.

• Fetal complications.

a. Juvenile diabetes.

b. Birth asphyxia.

c. Premature baby.

d. Macrosomia.

e. Polycythemia.