Approach to diabetes in pregnancy Quiz: Ace Your Exams

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A 27-year-old woman, gravida 2 para 1 at 12 weeks of gestation, presents to the clinic for her first prenatal visit. The patient reports feeling well and has no concerns. Her first child, delivered two years ago, had a birth weight of 3.2 kg (7 lbs). She has a history of irregular menstrual cycles and was diagnosed with polycystic ovarian syndrome (PCOS) five years ago. Family history is significant for type 2 diabetes mellitus in a first cousin. She does not smoke or consume alcohol. Blood pressure is 135/85 mm/Hg. Body mass index is 25 kg/m2. The rest of the vitals and physical exam are within normal limits. Which of the following features of this patient’s history or physical exam indicates the need for early screening for gestational diabetes mellitus?

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