Scenario:

Patient is a 28 years old Filipino mother, residing currently in Quezon City who is now on her
second pregnancy, has one live birth and no abortion noted. Patient is seen for prenatal care at 24
weeks gestation. The patient’s obstetric history includes a spontaneous vaginal delivery of a 9lb
80 oz male infant at 40 weeks gestation. The patient reports that the child is doing well. Her
family history revels that her mother has type 2 diabetes mellitus and now patient is diagnosed
with gestational diabetes class A1 (manage it through diet and exercise.)

Risk Factors
 A number of risk factors are associated with gestational diabetes, including:
 Being overweight
 Giving birth to a baby that weighed more than 9 pounds
 Having a parent or sibling with diabetes
 Having had gestational diabetes in the past
 Having glucose in your urine
Initial management includes dietary modification and blood glucose monitoring.

N: Hi ma’am, siyak ni Jeanne Mari iti caoyan RHU, since atta pandemic, indirekta ak ni Dr.
Pamplona nga siyak pela mangasikaso kanyam ma’am. Kumusta kan ma’am?
P: Naimbag a bigat nurse, dibale atta kuma ejay check-up ko kin Dra. Pamplona, ngem gapu
garod ta quarantine, marigatan ak met agbyahe-byahe ken mabuteng ak met gapo atoy sisasaad
tayo.
N: wen ma’am, usto lang met ayta imbagam mas lalo ket para metlang kanyam ken ji baby’m
ayta. Nasyaat kitdi maam ta adda atoy nga telecommunication atta pandemic’en.
N: Before anything else, mabalin maalak ejay name mo tapnu macheck ko ji data’m maam?
P: sure ma’am, siyak ni Gabriela Silang, tiga purok daya, vigan city.
N: Icheck ko pay maununa ejay data’m saka ta agproceed ma’am.
N: dibale nacheck kon ma’am, ti last visit mo pay ket diidi March, right before diidi quarantine.
Amin nga results mo ket nasyaat ma’am except ejay blood glucose mo, and nadiagnose naka ni
doc ti gestational diabetes. Bale anya inbaga kanyam ni doktora regarding ji diagnosis mo
ma’am?
P: yes nurse, nadiagnose nak diidi ni doc ti gestational diabetes class A1, ken time to time ket
kunkuntakek ni doc. Bale atoy ket mamodify pay met kanu through proper diet ken exercise
tapnu haan kumaro, ken agmonmonitor nak ti blood glucose ko, ni mister ko ti mangal-ala, isu
mangtartarabay kanyak.
N: Nsyaat nu kasjay ma’am. So bale atta, ifollow up ko lang dagijay inbilin ni doktora. Ji
vitamins mo ma’am, consistently’m metlang ba nga itatake?
P: datoy inted ni doctora nga supplements ko nurse ket ji ferrous sulphate + folic acid ken
vitamin C.
N: icontinous mo lang nga tumaren dagijay inbilin ni doc nga meds ma’am. How bout met dijay
exercise mo ma’am?
P: nu ti bigat, ket ikarigatak met ti agpagna pagna dita paraangan mi a, ken dagijay nalalag-an
nga maaramid ti balay kas panagsagad uneg balay, agluto pangaldaw kada kwa, kasjay nurse.
N: nasyaat met ma’am, han metla agsakit ji susom kada ji patong mo? Sumro?
P: Hamman ma’am, nu kasjay met ti kuek iyinanak, nu ngata ag hot compress ak.
N: nu kasjay met sumro ma’am, usto ejay imbagam iyinanam ken ipractice mo ejay panaganges
ti nauneg. Breathe in ka ma’am, then nu agbreathe out, saka ejay lips tayo ket iform tayo a kas
agsagawisiw.
N: ji panangan mo ma’am, kumusta met?
P: as much as possible, agluto ak ken da lakay ko ti natnateng, ngem ejay lang ta maadwak met ti
mangan ta ammum mettten, naimas lumamon, tapos madaddwak ti mangan ti inapoy. Nu ti rabii
met, han ko maiwasan ti agbinge eating, nu adda ti kilaban ket ejay, mas lalo nu agcrave ak ket
mapanpansin ko mostly sweets, cakes kada kwa metten.
N: Ma’am since diagnosed ka ti gestational diabetes, datoy ket mamodify lang thru proper diet,
and I suggest nga iwas-iwasan tay ti agpalalo nga mangan most especially iti rabii. Nu talaga met
haan maiwasan, mabalin tay gudwaen ejay panangan tayo into small frequent meals, meaning
ma’am ket mangan ka ti bigat ngem sakto laeng, han nga ji agpabusog ka unay, tapos kasjay tu
man nu sumarunon ton pangaldaw, on that way, mareach mo ejay preferred diet para ti
panagbuntis mo ken han nga ngumato ji blood glucose mo ken ti kastoy panangan mo ma’am,
ejay tiyan mo ket madigest na pay maununa ji inconsume mo ken maiwasan tay ti agka-
constipation.

In case agcrave or what, han ka nga nga over-eat ma’am. Nu man ji inapoy ma’am, mangan ka
latta ngem agportion control ka, make sure ka nga hank a ag over-eat. Kas met ji cravings mo
ma’am, iwasan tay pay ti mangan ti nasasam-it. Nu man fruits ma’am, ilimit tay ti atleast once a
day since ti fruits ket adda natural sugar na dagijay maam. Mangan ka latta ti nateng, mostly
dagijay na- rich in proteins, fish,chicken breast, broccoli, tokwa, kasjay, ken fiber rich
vegetables,fruits or meals a kas kuma saba, broccoli, green beans. Dagitoy ket nasyaat para ji
baby ken sika mommy.
P: kasjay ma’am? Sige ma’am. Ay ejay gayam blood glucose ko ket nangato met tungal alaen
mi?
N: apay anya oras ti panagala da ti blood glucose mo ma’am?
P: nurse paki-ulit? Han ka unay mangeg, aglalag ka ma’am.
N: usually anya oras ti panagala da ti blood glucose mo ma’am?
P: pangaldaw ma’am, kalpasan mi mangan.
N: Nu kasjay ma’am, instead of lunch, right before meals yu ti morning ken sakbay kay man
uminom or mangan ti bigat, dapat macheck ejay blood glucose yun, ken dapat macheck eyta 1 hr
before your first meal. Naala metla ma’am?
P: wen ma’am, bale 1hr before first meal ko ti bigat, dapat naala mi ji blood glucose kon?
N: wen ma’am. Usto eyta.
N: so far, okay met ji imbagam kanyak regarding ji exercise mo, nu sumro ji sakit ti patong kada
kwa, ag deep breathing exercise ka ma’am, aganges nauneg ken aginana. dajay lang regarding ji
diet mo ma’am, han mo liplipatan nga dapat han ka nga agpalalo, small frequent meals dapat,
ken yad-addu tay ti mangan ti nateng. Uminom ti addu nga danum Naala ma’am?
P: naala ma’am.
N: Ji panagala ji blood glucose mo, dapat 1hr before ti pamigat. Naala ma’am?
P: naala ma’am.
N: In case adda questions and concerns mo ma’am, feel free nga kontaken iti nurses ti caoyan
rhu. Inbatik ji contact number ko kanyamon ma’am just in case. Also amin nga napag-saritaan ta
ket maipadamag kin doktora tapnu maifollow up na metlang. Naibaga metla ni doktora ejay
katnu due date mon maam?
P: expected ko nga due date ko ket tun August.
N: okay m’am, don’t forget dagijay bilin ko, next check up mon to manen ma’am ket tun April
09, 2021. Have a good day ma’am.
P: thank you din ma’am.

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