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Sent: Fri 21/11/2008 4:15 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Class B
Sorry, I've been out of the office.
Her HgbA1c one month ago was 5.8. Her previous in the year prior to pregnancy when she wasn't officially diagnosed were in the 6.5 range. Postprandials are relatively normal.
el...I have no idea how to put her sugars in any other unit of measure.
Glen
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From: Andrew Folley <agfolley@hotmail.com>
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To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
Sent: Wednesday, November 19, 2008 12:57:33 PM
Subject: Re: Class B
Hww is her HbA1C and 1 hr post prandials. One approach would be to add glyburide to the regimen at 2.5 po BID I suspecvt however that she will need to be on insulin failry soon ie next 4-6 weeks.Implement increased fetal monitoring at 28-32 weeks pending clinical findings
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Date: Mon, 17 Nov 2008 22:38:20 -0600
From: dr99645@yahoo.com
To: ob-gyn-l@mail.obgyn.net
Subject: Class B
Just curious what others would do in this situation.
28 yo G1 at 15 wks with 'official' diagnosis of diabetes about 3 months before her pregnancy. In looking back at her records she had elevated fastings for at least two years before the diagnosis. She came in to the pregnancy on glucophage 1000mg bid.
She is now 15 wks and still on glucophage with fasting blood sugars between 95 and 112.
Here are my questions
Would you consider that a failure of the oral meds and start insulin?
Would you try glyburide first and if so when?
When would you start antepartum testing?
Thanks
Glen
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