Question

A 20 week primigravida patient has the following lab results: Fasting BG = 99, 1 hour following 50 g glucose = 175, and 2 hours following 50 g of glucose = 155. What does this indicate?

a. Patient needs rechecked in one month
b. Patient needs to begin insulin
c. Patient has gestational diabetes mellitus
d. This is a normal result

Answer 1

The lab results indicate that the patient has not returned to normal blood glucose levels within 2.5 hours after glucose intake, which suggests she may have gestational diabetes mellitus. She should see her healthcare provider for further evaluation and management.

Step-by-step explanation:

The patient's lab results indicate a fasting blood glucose (BG) of 99 mg/dL, which is below the pre-diabetes category described as 100-125 mg/dL, suggesting a normal fasting blood glucose level. However, the patient's 1-hour post-50 g glucose level is 175 mg/dL and the 2-hour post-50 g glucose level is 155 mg/dL. According to standard glucose tolerance test interpretation, these elevations suggest impaired glucose tolerance. In a healthy individual, the blood glucose should rise within an hour after glucose intake but return to normal levels within 2 to 2.5 hours. This patient's levels do not normalize as expected, indicating possible gestational diabetes mellitus (GDM).

Due to these results, the correct answer to the student's question is the patient has gestational diabetes mellitus. It is important for the patient to consult with their healthcare provider for a definitive diagnosis and to discuss the necessary steps to manage her condition, which may include dietary modifications, exercise, blood glucose monitoring, and possibly insulin therapy if indicated.