HbA1C after 9 months low carb

Cocosilk

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So I had gestational diabetes with my 3rd pregnancy, scraped in with a diagnosis when my fasting was 5.1 mmol. 1h and 2h were within acceptable limits. I did however end up on 22 units of insulin for the last few weeks of pregnancy and had the baby at 37 weeks and 5 days. Baby was 3.1kg and currently growing just under the 50th percentile.

In a follow up glucose tolerance test at 2 months post partum, both fasting and 2h were within acceptable limits but the 1h was 12.1mmol. I had been eating a few extra carbs in the lead up to that OGTT but possibly not as many as recommended. The note on the report was that I may have impaired glucose tolerance and to test again in a year.

I decided to ask for a HbA1c earlier though because any time I try to eat a few extra carbs again I would see 1h spikes to 8s, 9s and sometimes 10mmol. I got my first result yesterday (not quite 6 months postpartum). The result was 5.3% (34). I believe prediabetes is from 5.7%? Or maybe higher?

Anyway, what I am wondering is if after 9 months of mostly low carb (sometimes keto) my HbA1c is 5.3%, how much higher would it have been had I just gone on eating carbs this past few months again? Would I actually be prediabetic or even T2 maybe?

I'm tempted to try eating a few more carbs for the next few months to see what they are really doing to my levels but the only benefit would be having subsidised strips vs not being diagnosed and having to buy them myself if I want to keep an eye on things.

If some people can reverse their diabetes within a few months of eating low carb, that would probably mean I could bring on full-blown T2 within a few months too if I don't watch out, right?

I guess I should just feel fortunate that it was caught early during my last pregnancy and just stay fairly low carb, shouldn't I?

The only other thing with my blood results is that the C Reactive Protein came back at 5.4 mg/L (should be under 3.0). So there is inflammation present for some reason. But it could have been the tail end of a winter bug that we all had. My doctor didn't say anything about it. Would you normally want a second test in a few months to confirm it's not chronic inflammation?

EDIT: As an experiment I had some baked sweet potato chips with homemade mayonnaise. Before 4.8 mmol; 60 mins 9.4 mmol; 90 mins after 9.3 mmol; 2 hour 8.5 mmol.
 
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kitedoc

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The doctor who ordered your tests should be able to interpret them and if s/he cannot (and is honest about it) may need to refer you to someone who can, such as an endocrinologist.
 

Cocosilk

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818
Type of diabetes
Gestational
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The doctor who ordered your tests should be able to interpret them and if s/he cannot (and is honest about it) may need to refer you to someone who can, such as an endocrinologist.

You mean for the C Reactive Protein result?
 

ianf0ster

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If some people can reverse their diabetes within a few months of eating low carb, that would probably mean I could bring on full-blown T2 within a few months too if I don't watch out, right?
Hi Cocosilk,
While it is true that some can get their HbA1C down to pre-diabetic or even normal levels in a few months, that just means they have used up a lot of visceral fat.
T2D normally takes years or even decades to build up in a healthy, health conscious person. So even though you will probably remain more sensitive to carbs than a normal heathy person, it is unlikely that a little carb-creep you hurt too much in just a few months.
Now it is different when stretched out to a few years!
 
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kitedoc

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You mean for the C Reactive Protein result?
All the results, GTT etc ! The importance or otherwise of a 1 hr BSL on a GTT also needs to be sorted. Best wishes.
 

Cocosilk

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818
Type of diabetes
Gestational
Treatment type
Insulin
All the results, GTT etc ! The importance or otherwise of a 1 hr BSL on a GTT also needs to be sorted. Best wishes.

Yeah, I wondered about that. Was it being too low carb in the lead up or a genuine glucose impairment? I suspect the latter as others have done the GTT straight off a low carb diet and didn't see such spikes.

Pregnancy can probably also do things to your body that muck up your system a bit too I imagine.

And in this lovely hayfever season, I've started using Symbicort and Rhinocort so now I have to watch my blood sugar with those too.

You eat low carb, don't you?

Have you experimented with other ways of eating to see how they affected your blood sugar control as well as metabolism?
 

kitedoc

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In pregnancy they tend to use the BSL at one hour after as the 'high point' compared to at 2 hours for every other diabetic type.
Low carb diet for me means the high point moves out to 3 to 4 hours and is more gradual.
But in terms of GTT you would need to ask your doctor.