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Should gestational diabetes be treated?

New research may settle the question once and for all

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Originally published in Today's Parent April 2007

"You’ll find mixed opinions, very opinionated opinions, on the subject of gestational diabetes,” says Anne Kenshole, professor emeritus of medicine and obstetrics at Women’s College Hospital and the University of Toronto.

So what is this condition that has doctors debating — and where do they disagree?

Gestational diabetes — elevated blood sugar levels in late pregnancy — occurs when a woman’s body can’t meet increasing demand for the blood-sugar-regulating hormone insulin. Consequently, her blood sugar levels rise modestly — though not high enough to warrant a diagnosis of diabetes outside of pregnancy. But does that relatively slight boost in blood sugar levels cause problems — for example, increasing the likelihood of having bigger babies who are more apt to be injured during birth, or need to be delivered by C-section? And if so, does treatment (diet, exercise and, if necessary, insulin) reduce the risk?

Those are the million-dollar questions — and at least some doctors argue they haven’t been satisfactorily answered. “Some obstetricians are firmly of the opinion that gestational diabetes is a threat to the mother and child, and treat it very aggressively.” Kenshole observes. “Others, perhaps taking a more scientific view, say we just don’t know.”

What do you think?