This is a 40 year old, gravida VI para V, black female with an EDC of 3/18/90 at 29 weeks gestation who was admitted for blood sugar control for gestational diabetes and had a fasting blood sugar of 150. She had no other complaints during this pregnancy and had received RhoGAM 4/15/90. She had a past history of hyperthyroidism, status post partial thyroidectomy in 1976 on Synthroid 0.015 mg daily, endometriosis with right salpingo-oophorectomy in 1976, and other previous pregnancies. On admission, she was taking Synthroid and vitamins. On physical examination, her vital signs were stable, HEENT exam was normal, neck was supple, no adenopathy, thyroid full, scar present from partial thyroidectomy, lungs were clear, cardiac exam revealed a normal S1 and S2, no murmurs or gallops, breasts were without masses, abdomen was obese and gravid, cervix was long, thick and closed, extremities were without edema, and deep tendon reflexes were 1-2+. A finger stick blood sugar was 115 with her last meal being at noon. The impression was 29 weeks gestation with gestational diabetes admitted for glucose control, status post partial thyroidectomy and anemia. The plan was to admit her and check q4h blood sugars, begin an ADA diet and possible insulin. The patient was seen by the endocrinology service on admission and begun on a diet. Her blood sugars continued to be high with a fasting in the 120-150 range, so she was begun on insulin and was managed by the endocrinology service and controlled well on the insulin over the next several days, with her fasting blood sugar coming down to eventually 100-95 on 9/30/90. She was discharged home on insulin ten units of regular qAM and 16 units of regular and 16 units NPH qPM with follow-up to be with Dr. Gorneault of the endocrinology service.
Is the patient currently or have they ever taken vitamins
she was taking Synthroid and vitamins.