A 39-year-old woman was diagnosed with gestational diabetes at 16 weeks of pregnancy. This was her first and only pregnancy and she was treated with insulin (maximum 25 units per day). She delivered a healthy female neonate by cesarean section and three months postpartum, her fasting glucose was found to be 6.0 mmol/L and her 2-hour glucose value was 13 mmol/L. Her insulin requirements dropped to 6-12 units/day. Currently, 11 years later, at the age of 50, the patient presented for a checkup, and her quarterly A1c values were found to be less than 7.0% (53 mmol/mol).
The 2-hour PP values were 6.5 mmol/L (117 mg/dl). She had never experienced diabetic ketoacidosis or severe hypoglycemia. Over the last one year, she developed the need to drink water frequently, especially while swallowing food. She administered pre-meal insulin only when her meals contained more than 60 g of…
