January 14, 2007
Pregnancy
Question from United States:
I’m a type one diabetic who has been diagnosed with unexplained infertility. I do my best to keep tight control while I’m trying to conceive. My A1c is 5.8. However, I am not perfect all the time and I wonder if my occasional high blood sugars are causing my infertility.
According to my charts, I’m within my goals 92% of the time. However, every month there are always a handful of high blood sugars for a multitude of reasons, (went out to eat and underestimated the carbohydrates, got sick, forgot to bolus, etc.) Do you have to be a perfect diabetic to be able to conceive? Will one or two blood sugars out of range during your cycle make it so you can’t conceive? I usually have one or two off blood sugar readings a week and I test seven to eight times a day. Am I causing my infertility because I haven’t been able to keep my blood sugar in perfect range? I feel like a failure as a diabetic because I’ve never managed to go an entire cycle without an off blood sugar. I’ve asked my endocrinologist what A1c number is associated with reduced ability to conceive and I didn’t get an answer. He said an exact figure isn’t known and I should just try to do my best all the time. Can you shed any more light on this subject?
Answer:
You are doing a great job with your control. Your A1c of 5.8% is in the normal range. There are always going to be some that slip outside the range, even in the best of the best patients. You are doing so much better than most people. Please do not feel like your occasional high sugar is preventing you from becoming pregnant. I do not believe that is the case and do not want you to have tremendous guilt because of this. Many issues can play a role in fertility. In your case, blood sugars are just one of them. Remember, there are female issues and male issues, too. In terms of conception, many people become pregnant with less than optimal blood sugars. Successful pregnancy involves conception and subsequent normal development. Clearly, blood sugar control has a lot to do with a successful outcome. The risk of birth defects is tightly associated with control so that those women with type 1 diabetes who have normal A1c values come very close to the rate of birth defects for those women without diabetes. The higher the blood sugar, the higher the risk.
JTL
