Gestational Diabetes Mellitus (GDM)
Patient’s Problem
A 31-year-old female, Mrs. Shruti (name changed to protect identity), G2P1 at 28 weeks of pregnancy, came for her routine antenatal check-up, where her doctor informed her that her sugar test came back high. Over the past few weeks, she had been experiencing increased thirst, persistent tiredness, and occasional headaches. She had gained more weight than recommended during pregnancy and followed a mostly sedentary routine due to her desk job. She was advised to consult an MD physician in Vadodara or a lady physician in Vadodara for proper evaluation and further testing.
Diagnosis
Based on her symptoms and pregnancy screening, the doctor suspected gestational diabetes.
Findings included:
Physical Exam:
Her vitals were stable (BP 122/78 mmHg, HR 88 bpm). Fundal height matched her gestational age, fetal heart rate was normal at 140 bpm, and there was no swelling in her legs.
Glucose Tests:
Her glucose challenge test showed a high value of 162 mg/dL.
A follow-up 100 g oral glucose tolerance test revealed two elevated values (fasting 98 mg/dL, 1-hour 198 mg/dL, 2-hour 170 mg/dL, 3-hour 130 mg/dL), confirming gestational diabetes mellitus.
Ultrasound:
Fetal growth was normal (50th percentile) with normal amniotic fluid.
The doctor diagnosed her with Gestational Diabetes Mellitus (GDM), Class A1.
Treatment
Mrs. Shruti was managed with a structured plan to keep her blood sugar within the recommended range.
Lifestyle and Diet Modification:
She was referred to a dietitian for a balanced pregnancy diet with controlled carbohydrate intake, whole grains, vegetables, and lean proteins. She was advised to take smaller, more frequent meals and walk for 30 minutes daily. Such early interventions are commonly recommended by the best MD physician in Vadodara and experienced lady doctors in Vadodara.
Blood Sugar Monitoring:
She was guided to check her fasting and post-meal sugar levels at home, with target values explained by her clinician.
Medication (If Needed):
Since her sugars were mildly elevated, she was classified as A1 GDM and did not initially require medicines. If her readings increased later, insulin would be considered.
Fetal Monitoring:
Regular growth scans were planned to monitor for signs of macrosomia or excess amniotic fluid. Non-stress tests would be added later if needed.
Delivery Planning:
The aim was to maintain good sugar control during labor and avoid early induction unless medically necessary. Birth planning included preparing for the possibility of a larger baby.
Postpartum Follow-Up:
She was advised to undergo glucose testing 6–12 weeks after delivery and remain on yearly diabetes screening. Breastfeeding was strongly encouraged.
Result
Her prognosis is excellent with timely diagnosis and lifestyle changes. At her 6-week follow-up, her sugar readings had improved, and she did not require medication. Fetal growth remained normal, and she reported feeling more energetic after adjusting her diet and activity.
If left untreated, gestational diabetes can lead to complications such as excessive fetal growth, difficult labor, neonatal low blood sugar, and an increased risk of the mother developing type 2 diabetes later.
