Susan:
Someone from the list may have already answered your question regarding GDM.
Just a bit on GDM. Gestational DM usually occurs around 24-28 weeks and it
is common to be tested for this at this gestational age, if there has been
any history of stillbirth,macrosomia,or previous GDM then women will be
tested sooner.  Some women can control this with diet and exercise some
women have to use diet exercise and insulin to control it. Usually due to
insulin resistence that comes from the hormone surgence that is great at
this time of the pregnancy,the more pregnant they become the more insulin
resistent a mother can become so diet exercise are important but insulin
can be a possiblility. We like to keep the maternal glucose levels tight .
Capillary blood is approximately 10-15 % lower then the central venous
blood so this is for the tight control in home blood glucose monitoring.
FBS 70-90mg/dl
1 hour post prandial 100-130mg/dl( this means 1 hr after the first bite of
food)
These values coach  us  on the size of the baby and what type of
environment the baby is swimming in during the noc when asleep
What we look for in  the GDM mother is LGA, hypoglycemia, jaundice, the
possibiltiy of stillbirth mostly we want to prevent a macrosomic baby &
hypoglycemia when the baby is born.Remeber this is for GDM only, we do
preconception care for TYPE 1 DM and we put Type 2 on insulin.
These are guidelines from the Sweet Success Program from the state of CA.
Sincerely
Jean De Lapp,BSN,CLC

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Does anyone have information about gestational diabetes?  A former
client has just been diagnosed at 32 weeks with g.d. - 2nd pregnancy, 39
years old.  From the glucose levels, it appears mild with only dietary
changes recommended.  The mom is very worried that
she "has caused her baby harm" and is even more worried about birth and
bf outcome.  I photocopied the WHO recommendations but can't seem to
find additional information specifically on g.d.  The literature and
ref's I have refer to insulin dependent mothers.

TIA.

Susan Nachman-Srebrnik, IBCLC
Broiling in Ranana, Israel

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