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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.

Select Relevant Investigations
HbA1c

Performed

Her HbA1c level is 6.3%
100g 3hr OGTT

Performed

At 1 hour: 190 mg/dL (normal: < 180)
At 2 hours: 157 mg/dL (normal: < 155)
At 3 hours: 140 mg/dL (normal: < 140)
Urine Dipstick for Glucose

Performed

The dipstick test is positive for glucosuria
Urine protein test

Performed

Trace amounts of protein are noted

Select Relevant Management
Insulin stat
ACE Inhibitors
Monitor Blood Pressure
Deliver at 38 weeks