Abstract

Once upon a time, I had the task of analyzing the glucose diaries of 322 type 1 diabetic women who performed 8-10 self-monitored blood glucose tests a day for at least 14 days before conception and throughout pregnancy including labor and delivery and a month postpartum [1]. I always thought that maternal hyperglycemia was the villain that caused malformations and macrosomia, but there was no concrete evidence that glucose was the main culprit [2]. I spent hours poring over the data and all of a sudden the answer appeared: the highest blood glucose of the day, not the average or the pre-prandial glucose, related to macrosomia. I asked the statistician to confirm my crude observation and thus the landmark paper was published in 1991 and validated my observation [3].