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March 14, 2005

A1c (Glycohemoglobin, HgbA1c), Family Planning

Question from Alabama, USA:

I am 25 years old and have had diabetes for 17 years. I have type 1 diabetes and have low thyroid. I have been trying to get pregnant for a year now. I have been reading the Diabetes Dictionary portion of this web site and read about the subgroups of type 1 diabetes. How do they test to see if you have type 1A or 1B? Also, does this affect your fertility at all? My A1c is 7.2 and I can't seem to get it any lower. Is there a difference in the way that doctors treat the two types (1A or 1B)?

Answer:

There is no fundamental difference in how you would be treated. An A1c of 7.2% is not considered good enough to consider getting pregnant. It is important that you contact your physician treating you for your diabetes and discuss your treatment and goals, in light of your desire to get pregnant. I tell my patients that the A1c should be normal on at least two consecutive readings to indicate good durable control. The risk of birth defects is higher with higher A1c levels. The risk of defects can be decreased by having conception occur at a time when the blood sugar values are in the normal range. This cannot be stressed enough. Since your control is not optimum, please contact your physician.

JTL