A lot of studies and articles focuses on the risks of being pregnant and diabetic at the same time. But there can also be various other complications and issues to look at apart from having problems with insulin. As one of them is a high HbA1c (glycated hemoglobin) level that has links to a risk of adverse pregnancy outcome. This claim is supported by new and progressive research. Pregnancy as such always draws extra attention and discoveries.

As the main problematic issue with high HbA1c is the risk of macrosomia, which means that the newborn has an excessive birth weight. Nowadays more and more babies are born in size that is not suitable to deliver them naturally. Thus also in America is high C-section is high. According to National Partnership for Women & Families, about 1 in 3 women in America have C-section.[1]

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HbA1c levels

HbA1c is “when hemoglobin, a protein in red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming ‘glycated.’”[2]

As a measurement point if a woman has pre-existing type 2 diabetes, is HbA1c < 6.5. New research from “the Department of Endocrinology and Nutrition at Hospital del Mar (Barcelona, Spain).”[3] They estimated 1228 non-diabetic women and their pregnancy outcomes. The findings show that HbA1c of 5.9-6.4% was linked to an increased risk of macrosomia and preeclampsia. That was not the case with a woman whose HbA1c levels were lower than 5.9%. This approach also is aimed to help as an additional help in appraising glycemic status.

Importance of glycemic control

The beginning of each pregnancy is crucial as fetus forms the major organ systems and it is most vulnerable to damage from substances like high blood glucose. The American Diabetes Association also states that good glycemic control in the first trimester throughout pregnancy has links to a lower frequency of maternal, fetal, and neonatal complications. The best option is to follow the glycemic level control about 2-3 months even before planning to get pregnant. If HbA1c is higher than 10%, it is strongly suggested to avoid pregnancy until maintaining good glucose or diabetes control. HbA1c control also can help to avoid developing diabetes during the pregnancy. It is also worth reading also about high levels of HA1c that can cause similar problems.

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HbA1c target

For women with diabetes, the target is 43 mmol (6.1%) or lower. Generally, before meals, it should be 3.5-5.9 mmol/l, 1 hour after meals: 7.8 mmol/l or less.[4] If the pregnancy is unplanned, the target of the HbA1c is to achieve 43 mmol/mol as soon as possible. Board certified nutrition specialist Chen Ben Asher notes that this might not be easy and it is important always to consult specialists. After the pregnancy, it is still recommended to keep HbA1c level 6.5% or lower. Sugar itself is harmful to everyone, and there is no denying to that. There are also numerous other health problems related to sugar that a person should try to avoid. To follow HbA1c level is important for women with diabetes as well as the ones who risk to develop it.

 

Reference:

[1] Cesarean Section (C-section). Accessed from: http://www.childbirthconnection.org/giving-birth/c-section/?referrer=https://www.google.si/rel=”nofollow”

[2] Guide to HbA1c. Accessed from: http://www.diabetes.co.uk/what-is-hba1c.htmlrel=”nofollow”

[3] Elevated HbA1c During Early Pregnancy Linked to Adverse Obstetric Outcomes in Women without Pre-existing Diabetes. Accessed from: http://healthcareinstituteforclinicalnutrition.com/clinical-relevance/elevated-hba1c-during-early-pregnancy-linked-to-adverse-obstetric-outcomes-in-women-without-pre-existing-diabetes/rel=”nofollow”

[4] HbA1c and Pregnancy. Accessed from: http://www.diabetes.co.uk/pregnancy/hba1c-and-pregnancy.htmlrel=”nofollow”