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May 28, 1999

Gestational Diabetes

Question from Pennsylvania, USA:

I delivered a 7 pound, 9 ounce baby boy several days ago. He was delivered at 37 weeks as I had been diagnosed with both pregnancy-induced hypertension and gestational diabetes with multiple complications during the pregnancy. The gestational diabetes had been diet controlled only and blood sugars remained mostly in the normal range during the last 2 months of pregnancy. Since birth, his blood sugars has been unstable ranging anywhere from 24 to 78. He has been asymptomatic with these episodes except possibly for some lethargy. I wanted to know whether this is a transient thing because of my gestational diabetes or if I should be concerned about other causes. I have asked his neonatologist some of these questions, but he just gives vague answers about insulin production which I am well aware of since I am a registered nurse. What could some of the other causes for this hypoglycemia be and is it too early to be really concerned about other causes since he is only 4 days old. I am also interested in what you would recommend for the treatment at this point since he is presently in a small local hospital and only under the care of a neonatologist as opposed to a pediatric endocrinologist.

Answer:

Neonatal hypoglycemia from maternal gestational diabetes is usually transient, lasting a few days. This is due to excess insulin production by the baby. As the baby adjusts to a more normal glucose intake, the symptoms should improve. If there is no improvement, then additional tests for other metabolic disorders such be obtained. You should discuss this further with the pediatrician taking care of your baby.

OWJ