My wife had an slightly elevated reading on her one hour blood test. They sent her to take the three hour test and one out of three readings came back high. The plan is to treat her with diet and exercise and a new sonogram. She is presently 30 weeks along. What is the risk to her and the baby? What is the risk to her and the baby after it is born?

One abnormal value on the three hour glucose test does not make the diagnosis of gestational diabetes. However, starting a diet is reasonable. Depending on how the baby is growing, it may be worth repeating the test at 36 weeks of gestation since some mothers show delay in developing significant insulin resistance during pregnancy. If her blood sugar control remains normal, then there is no additional risk to her or the baby. If the diagnosis of gestational diabetes is confirmed, then this can be managed without a significant risk to mother or baby. The main problem is excessive fetal growth and/or transient hypoglycemia as a newborn. The pediatricians know about this possibility and will be prepared to manage it.

OWJ