UNIVERSITYOFSINDHJAMSHORO
DEPARTMENTOFZOOLOGY
Questionnaire: To Understand "GESTATIONAL DIABETES MELLITUS”, Its Causes,
Effects, Management, And Treatment
PATIENT'S PERSONAL INFORMATION
NAME:________unzila adnan_ AGE:_________ 31 years old___
WEIGHT:____________________57 kg____ CITY:_______________milton______ DATE OF
VISIT:_______________3 February___
Family History
1. Do you have the family history of diabetes?(Mother/Father/Sister/Brother)-----------------------yes mother --
2. --yes-----Yes/No
3. Were you aware of your family's history of Diabetes before your Gestational
Diabetes?-----------------yes---Yes/No
4. Were your family members diagnosed with Gestational Diabetes during their
pregnancies---------------no--Yes/No
5. Do you believe that genetic factors contributed to your GDM diagnosis?---------------------------may be -----------
Yes/No
OTHER QUESTIONS
1. Were you diabetic before pregnancy?--------------------no-----------------------------------------------------------------Yes/
No
2. When were you diagnosed with GDM? What was the stage of pregnancy at that time? __________________2
triminister____
3. Number of Pregnancy?---------------------------------second------------------------------------------------------------( 1st /
2nd/ 3rd)
4. If you had a baby before, did you suffer from GDM during that pregnancy
also?-------------------no--------------Yes/No
5. Have you had diabetes even after delivery of baby?-------------------------------------------------------no-------------Yes/
No
6. Were you aware of the risk factors of GDM before your diagnosis?------------------------------------yes--------------
Yes/No
7. Are you gaining weight more than the normal level during
pregnancy?-----------------------no----------------------Yes/No
8. Do you suffer from hypertension during pregnancy?------------------------------------------------no-------------------Yes/
No
9. Did you suffer from preterm birth?----------------------------------------------------------------------------------no------
Yes/No
10. Do you suffer from any heart disease during pregnancy?------------------------------------no--------------------------Yes/
No
11. Do you suffer from urinary tract infection ?----------------------------------------------------------------------no--------
Yes/No
12. Did you experience any difficulties in managing your blood sugar levels during pregnancy
?---------no----------Yes/No
13. Did you ever heard about GDM before experiencing it ?---------------------------------------------yes------------------
Yes/No
14. Did you face other problems during pregnancy due to GDM?--------------------------------------------no-------------
Yes/No
15. Did you receive any support or counseling on GD management from anyone?----------------------no---------------
Yes/No
16. What is your average blood sugar level during pregnancy ?_________________________________180 after
dinner_____
17. How often do you check your blood glucose level ?__________________________________________3 time a
day_________
18. Have you had a miscarriage? If yes, how many times ?_______________________________________no____
19. Did you experience any symptoms before being diagnosed with GDM?
_______________________________no_____________________________________________________________
20. What advice or recommendations would you give to other women who are diagnosed with GDM during their
pregnancy?
______GDM is common in pregnancy don’t take tension just focus in your
diet...._______________________________________________________________________________
____________________________________________________________________________________________
QUESTIONS REGARDING BABY
1. Is your baby fatty? Weighed more than normal weight of
baby?--------------------------------------no--------------Yes/No
2. Does your baby have diabetes?----------------------no---------------------------------------------------------------------
Yes/No
3. Does your baby have other complications due to GDM?------------------------------------------------------no-------Yes/
No
4. If you have had a baby before, did your baby experience any complications or health issues due to
GDM?---Yes/No no
5. If you have had a baby before, did your baby need to be monitored for blood sugar levels or other health
parameters? Yes sometimes
Yes/No
-
MEDICINES AND OTHER TREATMENTS
1. Were you prescribed medication to manage your blood sugar level?----------------------------------
glucophage-------------Yes/No
2. Were you satisfied with the effectiveness of medication in controlling your blood sugar level?--------yes--------
Yes/No
3. Did you experience any side effects from the medications prescribed for GDM?------------------------yes---------
Yes/No
4. Were there any lifestyle changes recommended alongside medication, such as dietary modifications or increased
physical activity?-----------------------------------yes------------------------------------------------------------------------------
Yes/No
5. Did you have regular follow-up appointments with your healthcare provider to monitor your medication and
treatment plan?-------------------------------------yes-------------------------------------------------------------------------------
Yes/No
6. What medicines do you take to treat GDM?
__________________________________glocophage______________________
7. What are the steps taken by you to prevent this disease?
________________________________________________________________mantain your mental health.2
2)focus on your diet
3) physical exercise______________________________
______________________________________________________________________________________________
8. Do you have any suggestions or feedback on how GD treatment and management could be improved for other
patients?
Just take good diet
Physical activities
Mental health
Water intake
______________________________________________________________________________________________