Case history
Case history
A 28-year-old woman first presents for antenatal care at 24 weeks of gestation. Past medical history is notable for irregular periods and class I obesity (BMI 30 kg/m²). The results of a 75-g oral glucose tolerance test performed after an overnight fast are: fasting glucose 5.8 mmol/L (105 mg/dL); 1-hour glucose 11.1 mmol/L (200 mg/dL); and 2-hour glucose 8.9 mmol/L (160 mg/dL).
Other presentations
GDM is usually diagnosed following assessment for risk factors followed by elevated plasma glucose levels on testing. Less frequently, patients may present with symptoms of hyperglycaemia including polyuria or polydipsia. In the absence of glucose testing, the presence of macrosomia (birth weight >4.5 kg) raises suspicion that pregnancy may have been affected by unrecognised GDM. Occasionally it may be difficult to distinguish GDM from undiagnosed pre-existing type 2 diabetes. Infrequently, type 1 diabetes may present during pregnancy.
Use of this content is subject to our disclaimer