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Case Study: A 36-Year-Old Woman With Type 2 Diabetes and Pregnancy

	Presentation

 
C.M. is a 36-year-old Spanish-speaking Mexican-American woman with a 3-year history of type 2 diabetes. She was seen in her primary physician’s office because of a missed menstrual period; a pregnancy test was positive.

Her past obstetrical history included five vaginal deliveries and six miscarriages. All of her previous pregnancies occurred before the diagnosis of diabetes. Her previous medical care was in Mexico. She was never told of any glucose problem during her pregnancies, and she does not know the birth weights of her children. At the time of referral, she was 8 weeks pregnant and taking glyburide 10 mg twice daily. She was checking her blood glucose once daily in the morning with typical readings between 180 and 220 mg/dl on a plasma-referenced meter. Family history was positive for diabetes in her mother.

Her height was 62 inches, and her weight was 198 lb. Other than mild acanthosis nigricans and obesity, her physical examination was normal. She had no retinopathy and no evidence of neuropathy. Her glycosylated hemoglobin (HbA_1c) level was 10.5% (normal <6.0%), and an office capillary blood glucose . . . [Full Text of this Article]

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