Glucose Tolerance Test
Case Study:
A woman presents to discuss the result of her glucose tolerance test. She is 42 years old and this is her sixth pregnancy. She has previously had three C-sections, one early miscarriage, and a termination of pregnancy. All previous diagnostic tests were normal as were her 11-14 week and anomaly ultrasound scans.
The woman is of Indian ethnic origin but was born and has always lived in the U.S. She is now 26 weeks gestation and a glucose tolerance test has been ordered.
Examination
The body mass index (BMI) is 31. Blood pressure is 146/87. The fundal height is 29 cm and the fetal heart rate is normal on auscultation.
Urinalysis: 1+ glycosuria
Glucose tolerance test (glucose drink): 185 mg/dL
2 hour glucose tolerance test: 160 mg/dL
Questions:
- How would you document her obstetric history (GTPAL)?
- What is the diagnosis and on what criteria can this be made?
- What are the differential medical diagnoses?
- Discuss the major risk factors for your diagnosis?
- What is your treatment plan for this patient?