In response to research confirming that even small elevations in blood sugar during pregnancy can lead to sick babies, an international panel of experts is recommending sweeping changes in how gestational diabetes is diagnosed. But it is not clear if the ADA or the American College of Obstetricians and Gynecologists will endorse the proposed guidelines. Carol J. Homko, an associate professor of medicine with a joint appointment in obstetrics and gynecology at Temple University, says the recommendations may overwhelm already struggling obstetrics practices. “I worry that these practices may not have the resources to suddenly double or triple their gestational diabetes caseload,” she says.