Skill Checkup: A 33-Year-Old Pregnant Woman With Excessive Thirst, Frequent Urination, and Fatigue

Romesh Khardori, MD, PhD


August 22, 2023

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

The patient is a 33-year-old Black woman in the United States presenting with excessive thirst, frequent urination, and fatigue. At this visit, she is 24 weeks pregnant. Relevant history includes a diagnosis of prediabetes 3 years ago, which was managed with extended-release metformin 500 mg/d and did not progress. As a precaution, she discontinued metformin at the time her pregnancy was confirmed. The patient has never smoked, does not drink alcohol, and consumes about 12 oz of coffee daily. She is active in her daily life as a primary school teacher and does a weekly pregnancy yoga class. Relevant history includes mother and sister with type 2 diabetes (T2D).

At today's visit, her blood pressure is 150/90 mm Hg, body mass index 29.5 kg/m2, and in-office A1c level 7.0%.


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