Vignette 4
Bethany Poppe
Post University: American Sentinel School of Nursing and Health Sciences
N582: Advanced Practice Nursing II: Women's Health
Professor Danielle Atchley
June 28, 2026
, Vignette 4
Most Appropriate Diagnosis
Maria’s symptoms and laboratory findings justify the diagnostic criteria for type 2
diabetes mellitus (T2DM) as outlined by the American Diabetes Association (ADA, 2026). She
presents with an A1C of 6.9 percent, which is the ADA threshold of 6.5 percent or higher for
diagnosis. Additionally, her fasting plasma glucose is 130 mg/dL, above the 126 mg/dL cutoff.
Maria is also experiencing classic symptoms of hyperglycemia, such as polydipsia, nocturia, and
fatigue which strengthens the clinical diagnosis, since the ADA requires only one abnormal
value in the presence of symptoms for confirmation (American Diabetes Association
Professional Practice Committee, 2026). Furthermore, her history of gestational diabetes is a
significant risk factor, independently increasing her likelihood of developing T2DM.
Vounzoulaki et al. (2020) reported that women with a history of gestational diabetes have nearly
a tenfold greater risk of developing T2DM than women who remained normoglycemic during
pregnancy. Because A1C testing may underestimate glucose control early postpartum, the ADA
recommends screening women with prior gestational diabetes with a 75-g oral glucose tolerance
test between 4 and 12 weeks after delivery (American Diabetes Association Professional Practice
Committee, 2026).
Maria also has several factors that further increase her risk for T2DM and cardiovascular
disease. Her body mass index is 33.6 kg/m², which falls within the obese range. Her blood
pressure is 144/88 mmHg, consistent with stage 2 hypertension and requiring repeat
measurement for confirmation (American Heart Association, 2025). Her LDL-C of 148 mg/dL,
HDL-C of 41 mg/dL, and triglycerides of 212 mg/dL indicate dyslipidemia and increased risk of
atherosclerotic cardiovascular disease. Comprehensive TSH of 2.1 ml/UL and a normal
Bethany Poppe
Post University: American Sentinel School of Nursing and Health Sciences
N582: Advanced Practice Nursing II: Women's Health
Professor Danielle Atchley
June 28, 2026
, Vignette 4
Most Appropriate Diagnosis
Maria’s symptoms and laboratory findings justify the diagnostic criteria for type 2
diabetes mellitus (T2DM) as outlined by the American Diabetes Association (ADA, 2026). She
presents with an A1C of 6.9 percent, which is the ADA threshold of 6.5 percent or higher for
diagnosis. Additionally, her fasting plasma glucose is 130 mg/dL, above the 126 mg/dL cutoff.
Maria is also experiencing classic symptoms of hyperglycemia, such as polydipsia, nocturia, and
fatigue which strengthens the clinical diagnosis, since the ADA requires only one abnormal
value in the presence of symptoms for confirmation (American Diabetes Association
Professional Practice Committee, 2026). Furthermore, her history of gestational diabetes is a
significant risk factor, independently increasing her likelihood of developing T2DM.
Vounzoulaki et al. (2020) reported that women with a history of gestational diabetes have nearly
a tenfold greater risk of developing T2DM than women who remained normoglycemic during
pregnancy. Because A1C testing may underestimate glucose control early postpartum, the ADA
recommends screening women with prior gestational diabetes with a 75-g oral glucose tolerance
test between 4 and 12 weeks after delivery (American Diabetes Association Professional Practice
Committee, 2026).
Maria also has several factors that further increase her risk for T2DM and cardiovascular
disease. Her body mass index is 33.6 kg/m², which falls within the obese range. Her blood
pressure is 144/88 mmHg, consistent with stage 2 hypertension and requiring repeat
measurement for confirmation (American Heart Association, 2025). Her LDL-C of 148 mg/dL,
HDL-C of 41 mg/dL, and triglycerides of 212 mg/dL indicate dyslipidemia and increased risk of
atherosclerotic cardiovascular disease. Comprehensive TSH of 2.1 ml/UL and a normal
