Pregnancy - what was HbA1c when you got the go-ahead

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kdg100 DAFNE Graduate
King's College Hospital, Camberwell
1 post

Hi,

My husband and I are planning to start trying for a family later this year. I have an appointment at the end of June with the consultant to discuss this. My last HbA1c was 6.8%, but have read that the ideal for pregnancy is 6.1% or below. I'm worried then the hospital will not give me the 'go-ahead' with my levels as they are and am struggling to drive things down further.

Just wondering what other people's experiences were when they kicked off the pre-conception stage of having a baby with diabetes? Thanks!

Vickyp DAFNE Graduate
Durham Diabetes Network
137 posts

At my preconception clinic I have to keep HbA1c around 43...not sure what that is in %. I did get it to 40 once but was having about 3 hypos a day...a risk of a low HbA1c. The target range for BGs I was given is between 4-6 pre-parandial and below 7.5 post-parandial. It is hard work trying to keep to the tight targets...my insulin pump has helped loads with this!

Garry DAFNE Graduate
North Lincolnshire
331 posts

Here is a copy/paste from an old discussion:

A guide to the new values expressed as mmol/mol is:

Current DCCT aligned HbA1c(%) New IFCC HbA1c (mmol/mol)
4.0 - 20
5.0 - 31
6.0 - 42
6.5 - 48
7.0 - 53
7.5 - 58
8.0 - 64
9.0 - 75
10.0 - 86
What are the targets in new units?
The equivalent of the current DCCT HbA1c targets of 6.5% and 7.5% are 48mmol/mol and 58mmol/mol in the new units, with the non-diabetic reference range of 4.0% to 6.0% being 20 mmol/mol to 42 mmol/mol.

End of Quote from diabetes.org.uk

I would have thought that your HCPs would be talking to you and using the worldwide accepted IFCC HbA1c (mmol/mol) units now.

Regards
Garry

Gemsa DAFNE Graduate
Taunton and Somerset Hospital, Taunton
20 posts

Hi kdg100. My HBA was 7.4%/57mmol when I asked if I had done enough yet to could consider safely concieving and I was told I was in the right ballpark but the lower I could get my HBA the better and the gold standard is 48mmol.

Don't forget that in an ideal world you need 3 months of folic acid 5mg doses (only available on prescription) prior to conceiving and then for the first 12 weeks. My diabetes team asked the GP to prescribe this way before my HBA was even remotely acceptable as they understand accidents do happen. There is no harm in taking this level of folic acid unecessarily i.e. if it takes you a year to get pregnant.

Since getting pregnant (I'm now 24 weeks) my care has been outstanding from the team (THANK YOU!) and my HBA has even been at "normal person level" (6%/42mmol) for two months running... although I know my next one will be higher due to some blips. In my opinion there is only so much a pre-conception HBA can reassure against... pregnancy hormones/changes in diet etc throw up a whole different set of challenges and lots of head scratching so a good HBA at the time is no guarantee - its confidence in making the smaller and bigger tweaks to ride the changes that is more important as the changes will change your HBA throughout. It is a lot easier for friends to accept my anal eating habits now as its because of the safety of my baby rather than because of the fussyness of the diabetic - people understand fear of miscarriage far more than they understand fear of bad HBAs even if one causes the other!

Vickyp DAFNE Graduate
Durham Diabetes Network
137 posts

I've been on 5mg folic acid for over 2 years now, we have since discovered we can't conceive naturally and as we are awaiting ivf I must continue with this high dose, as well as vitamin D tablets, so nothing wrong with taking the higher dose folic acid for extended periods of time.
I am also certain I was on this strength before my diabetes diagnosis as I naturally have low folic acid, so no adverse effects of this dose.
Good luck kdg100 and congratulations Gemsa Very Happy

Deepra 1 post

Hi, I was considered diabetic in 2011. My HBA1c was above 10 and I was only 29 years old (Female). As my brother was a Doctor and his treatment is more holistic, I called him in a shock to tell my HBA1C reading which was very very high. He gave me few tips and I religiously followed that. I immediately started brisk walking 1 hour every morning and cut down on portions I ate. In 3 months straight I lost 9 kgs and became very energetic. I used to be active when ever I could. When I tested my HBA1c, It was 6.4. It was like a new birth. I was feeling energetic almost all the time....

I conceived my second child in 2013 with HBA1C of 6.5.. I maintained by sugar level only by portion control and regular walking. I delivered a healthy (3 kg) girl child without insulin or any other medication, maintaining my HBA1C up to max of 6.5. So guys, if you regularly walk and eat less carbs supported by health fruits and vegetable and protein, controlling is very easy and YES POSSIBLE!
Infact during my pregnancy, I maintained my physical activity (Slow and comfortable pace walking) and food so well that I didn't gain weight at all..The baby took nutrition from me Smile and we both were super healthy.
Pls contact me for any doubts ...