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September 26, 2003

Gestational Diabetes

Question from Atlanta, Georgia, USA:

I am on four insulin injections per day to control gestational diabetesdiagnosed at 28 weeks. What is the general recommendation for blood glucose levels during labor in order to avoid hypoglycemia in the newborn?

Answer:

For my patients, I try to keep the blood sugar value less than 105 mg/dl [5.8 mmol/L]. This may require use of intravenous insulin in a slow drip which works very well. However, this does not always prevent neonatal hypoglycemia. If you have not been in good control up to the time of delivery, the baby is probably making excess insulin and a brief period of tight control will not change that level of insulin production. This is one reason I strive for fairly tight blood sugar control throughout the pregnancy. Luckily, the hypoglycemia is manageable and transient.

OWJ