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November 26, 2005

A1c (Glycohemoglobin, HgbA1c), Pregnancy

Question from Georgia, USA:

I am 23 and have had type 1 diabetes since I was eight years old, with good control, for the most part. My A1cs usually stay in between 6.7 and 7.0, with which my endocrinologist has always been fine. Recently, my husband and I have wanted to start having a child. My endocrinologist said that I was okay for the process and saw no reason as to why I cannot further pursue a child. On the other hand, my gynecologist said I should not think about this until I get my A1c under 6.0, otherwise, I am opening myself up for a mass amount of complications. Who is right? I do not want to put myself, or the child, at risk, but I know that there will always be a risk associated with pregnancy. I just don't want to add to that possible risk. So, should I wait until my A1c is under 6.0 or would it be okay to purse a pregnancy with my current A1cs?

Answer:

The closer you can get your hemoglobin A1c to the normal range, the lower the risk there is to a developing embryo. I think that a hemoglobin A1c in the 6.0 to 7.0% range is very good and should not deter you from a pregnancy. If you can get your value to less than 6.0%, then so much the better. However, if you are over-controlled (excessive hypoglycemic events), it may not worth the risk to you for a fraction of a percentage improvement in the hemoglobin A1c.

OWJ