Abstract
Tight control of diabetes has led to considerable concern regarding the occurrence of hypoglycemia in the non-gravid state since type I diabetic patients may manifest a defective counter-regulatory response to insulin-hypoglycemia. This concern has not been addressed with regard to the effect of maternal hypoglycemia on the fetus and ultimate childhood development. We have studied well controlled pregnant diabetics and found that hypoglycemia ( 60mg/dl) occurs as frequently as 30% of the time. This incidence may be related to the severity of diabetes judged by the White classification. Earlier studies evaluating the effect of maternal hypoglycemia on neurological and psychological development of offspring defined hypoglycemia according to either perinatal blood glucose levels or anectodal symptoms of hypoglycemia during gestation. Thus, the potential impact of hypoglycemia on the fetus is uncertain but has been inadequately investigated. To assess this problem, the occurrence of gestational hypoglycemia documented by capillary blood glucose monitoring with subsequent neurological and developmental testing is needed.
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