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Michael P. Carson, M.D., is an Obstetric Internist and Director of Obstetric Medicine for the Comprehensive Care Group in New Brunswick, NJ, as well as Chief of the Division of General Internal Medicine at St. Peter's University Hospital. He is also an Assistant Clinical Professor of Medicine and an Assistant Clinical Professor of Obstetrics, Gynecology & Reproductive Sciences at UMDNJ's Robert Wood Johnson Medical School. Dr. Carson is board certified in internal medicine and graduated from Temple University School of Medicine. His training in Internal Medicine and his fellowship in Obstetric Medicine were both at Brown University School of Medicine. For more information on Dr. Carson, please visit http://tinyurl.com/michaelcarsonmd.

What is Gestational Diabetes?

The body breaks down food into glucose which is then used as an energy supply. A hormone called insulin helps change glucose into energy.

As the pregnancy progresses, the hormones of pregnancy limit the effect of insulin in the body. About 3% of women who become pregnant develop "temporary" or "gestational" diabetes because the pancreas (where insulin is produced" is unable to keep up with the increased demand. This allows the amount of sugar in the blood to be too high. This is why most pregnant women are given a 1-hour "sugar" or "glucose tolerance test". If the 1-hour test is abnormal, then you are asked to take the more accurate 3-hour test.

My sugar test was high, what next?

This is not an emergency. The first step is to become educated about gestational diabetes. You will be referred to a clinical nutritionist who will teach you about the diet and how to monitor your blood sugars. About a week after these visits you will meet with a physician to review your blood sugar results. Not everyone requires medication to control their sugars. The first step is following a diet.

Can this affect my fetus?

Some of this excess sugar in the blood moves across the placenta to the baby, which may increase the risk for certain complications. After birth, the baby can develop low blood sugar since his or her body is used to producing extra insulin and it may take a while for it to adapt to the need for less insulin.

The best way to avoid complications is to follow the diet, monitor your blood sugar (usually 4 times a day), and maintain close communication with your obstetrician, obstetric internist, and diabetes team.

What can I expect during the pregnancy?

You may have to visit the doctor more often throughout the pregnancy than women without diabetes. Don't be alarmed if your doctor orders blood tests to check your kidney function, and non-stress tests or ultrasound exams to evaluate the condition of the baby and the placenta.

You may be asked to keep track of the baby's movements several times each day. Again, check your blood sugar at least 4 times a day (or more if ordered by your doctor) to be sure it stays at a safe level. Eat regularly. Don't skip meals.

After Pregnancy:

Gestational diabetes can predict the onset of diabetes later in life. Your medical doctor should check your sugar 4 to 6 months after delivery and then about every 2 years. Early recognition and treatment will decrease your risk of any complications.

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Created: 11/12/2000  -  Michael Carson, M.D.

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