As far as I know, the only reason to induce a woman with well-controlled diabetes is to reduce the likelihood of having a big baby and the problems that can go along with having a big baby, in particular, need for cesarean surgery or shoulder dystocia (the head is born but the shoulders hang up behind the pubic bone). The babies of women whose diabetes is under control are not at increased risk for other harms unless the mother experiences the serious complications affecting her health that can accompany long-term diabetes, a situation that doesn't describe you. You can see logically why the latter should be so: if your sugar levels are normalized by treatment, and you don't have any other medical complications, then you do not differ from a healthy pregnant woman who doesn't have diabetes. Here, then, is a systematic review of the medical research that addresses the "big baby" issue:

Obstet Gynecol. 2002 Nov;100(5 Pt 1):997-1002. 
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Expectant management versus labor induction for suspected fetal macrosomia: a systematic review.

·         Sanchez-Ramos L,

·         Bernstein S,

·         Kaunitz AM.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, laceType w:st="on">UniversitylaceType> of laceName w:st="on">FloridalaceName>, Jacksonville, Florida ostalCode w:st="on">32209ostalCode>, USA. luis.sanchez@jax.ufl.edu

OBJECTIVE: To systematically review and summarize the medical literature regarding the effects of expectant management and labor induction on mode of delivery and perinatal outcomes in patients with suspected fetal macrosomia. DATA SOURCES: We supplemented a search of entries in electronic databases with references cited in original studies and review articles to identify studies assessing management of patients with suspected fetal macrosomia. METHODS OF STUDY SELECTION: We evaluated, abstracted data, and performed quantitative analyses in studies assessing the outcome of patients with suspected fetal macrosomia. Observational studies and randomized trials were included in this systematic review. TABULATION, INTEGRATION, AND RESULTS: Twenty-nine studies were identified, 11 of which met our criteria for systematic review and meta-analysis. These 11 studies included 3751 subjects. Of these, 2700 were managed expectantly, and 1051 underwent labor induction. We calculated an estimate of the odds ratio (OR) with 95% confidence intervals (CIs) for dichotomous outcomes, using random- and fixed-effects models for outcomes. Summary statistics for the nine observational studies showed that, compared with those whose labor was induced, women who experienced spontaneous onset of labor had a lower incidence of cesarean delivery (OR 0.39, 95% CI 0.30, 0.50) and higher rates of spontaneous vaginal delivery (OR 2.07, 95% CI 1.34, 3,19); however, significant differences in these outcomes were not noted when the two randomized trials were assessed. No differences were noted in rates of operative vaginal deliveries, incidence of shoulder dystocia, or abnormal Apgar scores in the analyses of the observational or randomized studies. CONCLUSION: Based on data from observational studies, labor induction for suspected fetal macrosomia results in an increased cesarean delivery rate without improving perinatal outcomes. Although their statistical power is limited, randomized clinical trials have not confirmed these findings.

PMID: 12423867 [PubMed - indexed for MEDLINE]

The best way to avert harm from shoulder dystocia to either baby or mother is the Gaskin maneuver, which is getting onto all fours either when a big baby is anticipated and the care provider believes shoulder dystocia is likely or in response to it. It can be done even if the woman has had an epidural if she has a little assistance, but my personal recommendation would be to avoid an epidural when the odds are good, as they are in your case, that the baby is going to be on the large side. You will be able to push more effectively and in a greater variety of positions. Here is the study on the Gaskin maneuver. The abstract doesn't tell you this, but the study compares outcomes with other studies using other techniques, and the Gaskin maneuver wins hands down in terms of safely getting the baby born.

Bruner JP, Drummond SB, Meenan AL, et al. All-fours maneuver for reducing shoulder dystocia during labor. J Reprod Med 1998;43(5):439-43.

OBJECTIVE: To report on a large amount of clinical experience with shoulder dystocia managed primarily with the all-fours maneuver. STUDY DESIGN: The all-fours maneuver consists of moving the laboring patient to her hands and knees. Eighty-two consecutive cases of shoulder dystocia managed with this technique were reported to a registry through January 1996. RESULTS: The incidence of shoulder dystocia was 1.8%, and half of the newborns weighed > or = 4,000 g. Sixty-eight women (83%) delivered without the need for any additional maneuvers. The mean diagnosis-to-delivery interval was 2.3 +/- 1.0 (SD) minutes (range, 1-6). No maternal or perinatal mortality occurred. Morbidity was noted in only four deliveries: a single case of postpartum hemorrhage that did not require transfusion (maternal morbidity, 1.2%), one infant with a fractured humerus and three with low Apgar scores (neonatal morbidity, 4.9%). All morbidity occurred in cases with a birth weight > 4,500 g (P = .0009). CONCLUSION: The all-fours maneuver appears to be a rapid, safe and effective technique for reducing shoulder dystocia in laboring women.

In order to make an informed decision, you are entitled to information on the benefits vs. harms of all your options, including doing nothing. The fact that ACOG recommends a practice does not tell you anything about these. You may well wish to find out on what grounds ACOG recommends induction at 39 weeks. Don't allow yourself to be rushed into a decision. As a friend of mine says, "Deciding to induce labor is never an emergency." Finally, if, after considering the pros and cons of inducing labor vs. awaiting spontaneous labor, you decide to await labor, you should know that you have a right to informed refusal as well as informed consent.

One more thing to be aware of:  the tests of fetal well-being all have high false-positive rates, that is, the test says the baby has a problem when it doesn't. If a test comes up "iffy," repeating the test or doing a different test will reduce the odds of a false positive. Also, make sure you are not dehydrated before having amniotic fluid volume measured.

-- Henci