-Passage of large amount of glucose to the fetus induces fetal hyperinsulinemia. Insulin has an anabolic effect leading to increased size of the baby and visceromegaly. After birth and ligation of the cord, hyperinsulinemia persists leading to lowering of blood glucose to hypoglycemic level. -Macrosomia is the classic presentation of this Infant, birth weight more than 4 kg. The baby appears plethoric with plumby face . Birth injuries like fracture clavicle may occur.