I am 35 weeks pregnant, and for the first three months of my pregnancy, my blood sugars were extremely unstable and mostly on the low side due to extreme morning sickness. My A1c for that time period was 4.4% which was shocking to me. After the morning sickness left and my sugars went up, I went on the pump and have had stable sugars (110-130 mg/dl [6.1-7.2 mmol/L]) range. Is there is any evidence of how those low blood sugars (20-40 mg/dl [1.1-2.2 mmol/L]) could have affected my developing son?

Although the effects ofhyperglycemia on the fetus are known, how hypoglycemia affects the fetus is not as clear. It is not associated with any structural abnormalities. The fetus can tolerate maternal hypoglycemia to some degree, but has less glucose reserve (depending on the gestational age).

A transient low blood sugar is probably not a concern. In other words, if you suspected a low blood sugar based on symptoms, checked your glucose and then treated it, I believe that the baby would tolerate this without any difficulty. Hypoglycemia to the point where you are unresponsive may be a different matter. Unfortunately, there is no marker of hypoglycemia that can be measured in the baby. If the baby is active and growing well, then I suspect it got through the early part of your pregnancy without any difficulties.

OWJ