Clinical Diabetes 19:25-26, 2001
© American Diabetes Association ®, Inc., 2001
Case Study: Complicated Gestational Diabetes Results in Emergency Delivery
Ginny Lewis, ARNP, FNP, CDE
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Presentation
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A.R. is a 33-year-old caucasian woman initially diagnosed with diabetes during a recent pregnancy. The routine glucose challenge test performed between 28 and 29 weeks gestation was elevated at 662 mg/dl. A random glucose completed 1–2 days later was also elevated at 500 mg/dl. A follow-up HbA1c was elevated at 11.6%. Additional symptoms included a 23-lb weight loss over the past 3–4 weeks with ongoing "flu-like" symptoms, including fatigue, nausea, polyuria, and polydypsia.
A.R. had contacted her obstetrician’s office when her symptoms first appeared and was told to contact her primary care provider for the "flu" symptoms. She had called a nurse triage line several times over the previous 2–3 weeks with ongoing symptoms and was told to rest and take fluids.
She presented to her primary care provider 3 days after the HbA1c was drawn for ongoing evaluation of hyperglycemia. At that time, she was symptomatic for diabetic ketoacidosis. She was hospitalized and started on an insulin drip.
A.R.’s hospitalization was further complicated with gram-negative sepsis, adult respiratory distress syndrome, and Crohn’s disease with a new rectovaginal fistula. She was intubated as her respiratory status continued to decline and was transferred to a tertiary medical center for ongoing management. She required an emergency Caesarian section at 30 1/7 weeks gestation due to increased fetal distress.
A.R. had no family history of diabetes with . . . [Full Text of this Article]
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Questions
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Commentary
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Clinical Pearls
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Footnotes
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REFERENCES
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Copyright © 2001 by the American Diabetes Association.
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