Gestational Diabetic Mellitus (GDM) (Obstetrics)

Mrs April, 36 years old, primigravida at 26 weeks of gestation, was diagnosed with gestational diabetes mellitus (GDM) under diet control. During her subsequent antenatal visit, her oral glucose tolerance test (OGTT) ≥ 200mg/dl.  She was admitted to the antenatal ward for stabilization of glucose level. Dr. Lee has ordered subcutaneous insulin glargine 10 units daily. She was also referred to the dietician for diabetic diet counseling. She is scheduled for discharge after being hospitalized for 1 week.

Past medical and surgical history: Nil.

Family history: Mother has diabetic mellitus.

Drug allergy: Nil.

You are required to provide health teaching to Mrs  April on discharge as follow:

1. Explain GDM.
2. Identify risk factors, clinical manifestations and complications of GDM.
3. Teach the administration of subcutaneous insulin glargine and hypocount monitoring pre-breakfast daily and indicate the normal and abnormal value of hypocount reading of GDM
4. Explain the signs and symptoms hypoglycemia and hyperglycemia and its management.
5. Provide appropriate diabetic diet advice.
6. Advice on the importance of compliance to antenatal follow up with the Obstetrician.