A Comparison Between a “Terror” Reaction and a“Nonchalant” Reaction to the Diagnosis of Gestational Diabetes

Abstract

S.E., a 30-year-old woman who was gravida 2, para 1, was asked to take a 3-hour oral glucose tolerance test (OGTT) after her 1-hour 50-g glucose screen yielded a result of 150 mg/dl. She was 27 weeks pregnant and stated that this never happened in her first pregnancy and that she was extremely worried. Her OGTT results were: 1. Fasting: 78 mg/dl 2. 1 hour: 206 mg/dl 3. 2 hours: 173 mg/dl 4. 3 hours: 133 mg/dl Based on these results, she was diagnosed with gestational diabetes mellitus (GDM). Thus far in her pregnancy, she had gained 18 lb, and her blood pressure was normal. Her physician referred her to a high-risk perinatal medicine group for management of this diagnosis. S.E. terrified at the diagnosis, and the fact that she was now referred to a high-risk practice, intensified her concern. The consulting physician who saw her performed her usual new patient visit and related the risks of this disorder. These risks included macrosomia, earlier-than-term delivery, increased possibility of a cesarean birth, possibility of neonatal hypoglycemia, and potential need to inject insulin as the pregnancy progressed. She added that the mother's risk of developing GDM in a subsequent pregnancy was very high. S.E. was told she would be scheduled for weekly antenatal tests to ensure the health of the placenta and her baby starting at 36 weeks. She was also instructed about how to test her blood glucose, keep records, and fax in the results once per week. In addition, she was told to limit sugars and starches. S.E. left the office in …