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CC : Elevated blood glucose

A 35-year-old pregnant woman presents with elevated blood glucose and symptoms of polyuria and polydipsia. No weight loss reported. Further investigation reveals high anion gap metabolic acidosis and ketonuria.

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CC : Elevated blood glucose

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  1. CC : Elevated blood glucose • PI : She is a 35 year old pregnant woman ( G2P1A0) who was referred to the emergency room due to FBS = 284 . She is in sixth week of pregnancy . No abdominal pain , nausea , or vomiting . Polyuria and polydipsia from one week ago. No weight loss .

  2. PMH : DM + She had FBS = 125 2 years ago and FBS =158 , six months ago but didn’t visit a doctor and didn’t use any treatment . • FH : DM type II in her grand father and uncle who were treated with oral agent . No macrosomia in her past pregnancy . (3600 gr) No macrosomia in her mother . Her sister is single . • DH : Neg

  3. ROS : • Head and neck : Nl. Thyroid gland was 20 gr without nodularity. • Chest : Nl • Abdomen : Nl • Extremities : Nl

  4. PE : • Height :163 cm Weight :64 Kg BMI : 24.1 • PR :74 BP : 120/80 mmHg RR :12 OT :37 • She was not ill . • Head and neck : Nl , No retinopathy . • Chest : Nl • Abdomen : Nl • Extremities : Nl

  5. Lab Data : • WBC : 7.6 • HGB : 11.4 MCV : 75.9 • Plt : 399000 • BUN : 11 Cr : 0.7 • Cl : 101 • TSH : 1.8 T4 : 6.3

  6. Problem List : • Woman on sixth week of pregnancy • Polyuria and polydipsia • No weight loss • BS = 201 • High anion gap metabolic acidosis • Ketonuria

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