Problem
What is your "prescription" or overall recommendations for Lilly Lemon 46 years old, Weight 198 pounds, 5 foot 2 inches.
Lilly is a 46-year-old Spanish speaking Mexican American woman who is in her second trimester of pregnancy. Previous medical care was in Mexico. She has a first degree relative with type 2 diabetes. The patient's capillary glucose reading, performed in the clinic, was 193 mg/dl. She was instructed to return the next morning for a fasting venous plasma glucose, which was 143 mg/dl. Given this finding, the diagnosis of GDM was established. The patient was begun on both dietary and insulin therapy as an outpatient. Lilly has very little money, came to US with a boyfriend. She has no insurance coverage. She speaks and reads no English. She has three other small children at home.