A newly diagnosed insulin-dependent type 1 diabetic with good blood sugar control is at 20 weeks' gestation. She asks the nurse how her diabetes will affect her baby. What would the best explanation include?
1. "Your baby could be smaller than average at birth."
2. "Your baby will probably be larger than average at birth."
3. "As long as you control your blood sugar, your baby will not be affected at all."
4. "Your baby might have high blood sugar for several days."
2
Explanation: 2. Characteristically, infants of mothers with diabetes are large for gestational age (LGA) as a result of high levels of fetal insulin production stimulated by the high levels of glucose crossing the placenta from the mother. Sustained fetal hyperinsulinism and hyperglycemia ultimately lead to excessive growth, called macrosomia, and deposition of fat.
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