A 33-year-old woman was screened at 14 weeks' gestation for abnormal glucose metabolism and was diagnosed with gestational diabetes. The patient presented with early abnormal glucose metabolism, with an A1c of 5.9% (39 mmol/mol), which she has been managing with insulin as well as diet and exercise. She has also been taking a regimen of low-dose aspirin. Now at 24 weeks, the physical examination is notable for edema of the hands and feet. Her height is 5 ft 6 in and her weight is 164 lb. Her systolic blood pressure (SBP) is 162 mm Hg. The patient reports a family history of cardiovascular disease on her mother's side.