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December 28, 1999

A1c (Glycohemoglobin, HgbA1c), Family Planning

Question from Akron, Ohio, USA:

I am 29 years old and have been an insulin-dependant diabetic for 10 years. My husband and I are seriously considering having a child in the very near future. I am in close contact with my endocrinologist and Ob-Gyn. I have had a yearly eye exam since diagnosis also. I realize that each laboratory has a different "normal" range for HbA1c levels, but could you tell me what number you recommend for the preconception stages of planning a family? I am very close to achieving the level that my doctor and I have been striving for. I just want another perspective if you can provide it.

Answer:

The laboratory that I use reports the upper limit of normal for HbA1c to be 6.5. However, you should follow the level used by your endocrinologist.

OWJ
Additional comments from Dr. Quick:

Implicit in Dr. Jones’s reply is the thought that the HbA1c level before conception should be normal. This idea is widely thought to give the best chance for normal development of the fetus during the first few months of pregnancy, at a time when the baby’s organs are first developing.

WWQ