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chnpal

Planning a pregnancy

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chnpal

Hi,

 

I was recently diagnosed as diabeticby my gyno. My Fasting Blood Sugar is 128mg/dl,my GTT was 152mg/dll after two hrs and my HBA1C is 6.1. The diabetologist said I am prediabetic with Impaired Glucose Tolerance but my gyno doctor says I am diabetic :(. We were planning to start a family. Now I am really confused as to whether I should try for a pregnancy or not. If I am pre-diabetic then does the condition worsen post pregnancy and turn into full blown diabetes? Please help.

 

I am on Metformin 500 mg post dinner.

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Cormac_Doyle

The thresholds used to diagnose gestational diabetes are tighter than those used normally.

 

Generally, two fasting results above 6.5 mmol (120 mg) indicate either "diabetes" or "pre-diabetes" (depends on thresholds). You only had one fasting result, but it was in the danger zone (above 120). This is inconclusive (but is sufficient to trigger further testing).

 

Oral Glucose Tolerance test (OGTT or simply GTT)

Under 8.0 mmol (140mg) after 2 hours - normal response

Between 8.0 mmol (140 mg) and 10.0 mmol (180 mg) - impaired glucose tolerance (or pre diabetes).

Above 10.0 mmol (180 mg) - Diabetes

 

HbA1c (This is a measure of the amount of glucose bound to the red blood cells and thus is an indicator of the average blood sugar levels over the last 3 months)

- below 5: normal

- between 5 and 6.5: pre-diabetes

- above 6.5: Diabetes

 

Note that in pregnancy, these thresholds are tightened up ... and treatment will be initiated if HbA1c is above 6.0 and either the OGTT or fasting blood sugar readings were of concern. You ticked all three boxes!

 

After the pregnancy, your levels may be able to be controlled with lifestyle changes; you may see your diagnosis as "Gestational Diabetes", which most insurance companies will say is over once the baby is born. Nice for them, but statistically, the progression from gestational diabetes to full diabetes diagnosis is 100% (over 8 or more years). If you stay in contact and acknowledge that you need the lifestyle changes, you may head-off the medications (possibly permanently); if you assume the problem is over after the pregancy, I guarantee that in a couple of years the diabetes will be back ...

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diaboki

Since you are not pregnant, you do not have gestational diabetes. Your numbers indicate to me that you are in fact diabetic. Your gynecologist seems to be right on. There's no reason not to begin TTC, though. You will just want to really focus on getting your numbers where they need to be. I aim to keep mine below 6.0, and you don't have very far to go for that!

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diaboki

Can't figure out how to edit my own post. Just wanted to point out that I am not a doctor! So YMMV. But your gyno sounds right on the money to me. FWIW, I am also TTC (sort of -- doing IVF), so have some of the same issues.

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luciya
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I appreciate the concern which is been rose. The things need to be sorted out because it is about the individual but it can be with everyone. I like this particular article It gives me an additional input on the information around the world Thanks a lot and keep going with posting such information.

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