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July 27, 2001

Gestational Diabetes

Question from Irvine, California, USA:

I am 32 weeks pregnant, have gestational diabetes diagnosed at week 13, and I am worried about getting low blood sugar during the stress of labor and delivery because I am not allowed to eat anything to prevent nausea in active labor or in the event of a possible caesarean. My fasting is normal, and my one to two-hour after meals have been maintained well with diet. However, if I miss a meal, if it is later than three hours between them, or I exercise, my blood sugars can fall to 50-60 mg/dl [2.8-3.3 mmol/L] quickly, and I'm worried that without being able to eat that I may pass out or cause harm to the baby if I have hypoglycemia during labor. How can I prevent that?

Answer:

You will probably have an intravenous line during labor. Glucose can be given directly if you are showing signs of hypoglycemia If you were diagnosed with hyperglycemia at 13 weeks gestation, I am concerned that you may have type 2 rather than just gestational diabetes. You should plan to repeat your glucose testing after you deliver your baby.

OWJ