Timing of Delivery

Timing of Delivery

There are many points of discussion around Gestational Diabetes (GDM):- how to diagnose it, when to use insulin but a thorny issue is the timing of the delivery.  In the clinic I am sometimes asked “Do I have to be induced early?”  I feel this is more an obstetrical than diabetes related decision and I work with obstetricians I trust but that does not mean the decision should not be questioned.   Understanding the background knowledge can inform those questions.

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Day of Delivery for Gestational Diabetes

Day of Delivery for Gestational Diabetes

Months of hard work controlling your blood sugar and now it all comes down to some hours of labor that still needs good glucose control for the baby. If the sugar levels are high in the mom just prior to delivery this gets carried into the baby causing its pancreas to make extra insulin.  If the baby is then delivered there is no more sugar coming from the mom so the baby gets a low blood sugar, neonatal hypoglycemia.  The normal sugar in a healthy newborn can dip down to 2.2 mmol/L (40mgs/dL) – much lower than adults can tolerate.   Babies born to women with diabetes are more likely so have low blood sugars in the first few hours after birth.

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