Hba1c 38

[Sophie123lou]

Hi everyone. I was diagnosed with gestational diabetes at the end of my pregnancy. My doctor brought forward my 12 week hba1c blood test to 9 weeks postpartum as he wanted to see what was going on with my bloods near the end of my pregnancy. My result came back as 38mmol, I know this isn’t prediabetic but seems like the High end of normal… would you say it’s something to worry about? Is lower always better? Also as it was done 3 weeks early do you think it could be including some pregnancy hormones? I’m also pretty sleep deprived & do follow a healthy diet, walk a lot and am a normal weight but I did go a little mad on sugar when baby was born, could this affect results too?

 

[EllieM]

Hi @Sophie123lou would you like me to change the title of your thread to hba1c 38 after gestational diabetes?

38 mmol/mol is at the top end of normal so my guess is that your doctor will want to do another test in due course. (Edited to add, actually it's very much in the middle of normal so congratulations.)

People with GD are more prone to get T2 in later life so it is unfortunately something you'll want to keep an eye on, particularly if you're planning more children. (Congrats on your baby by the way). If you're planning another pregnancy you'll want to make sure your hba1c is fine before that.

Personally (massive disclaimer I'm not a doctor and didn't have GD) I would try not to worry too much about your hba1c at the moment, as you'll still be slightly affected by your pregnancy levels and as you say you are currently very stressed and sleep deprived. (Oh the joys of small babies: they do sleep at night eventually ).

Hopefully some posters with experience of GD will post soon. In the meantime, enjoy the new small person in your life, and once more congratulations.

 

[Ronancastled]

My doctor brought forward my 12 week hba1c blood test to 9 weeks postpartum

So your A1c (12 week average) was "polluted" with 3+ weeks of elevated bloods & still came in at 38.
My guess is your fine & another A1c in 3 months will be perfect.
Congrats btw.

 

[EllieM]

38 mmol/mol is at the top end of normal so my guess is that your doctor will want to do another test in due course.

Sorry, the cut off for prediabetes varies by country, 38 is definitely in the normal range everywhere but is near the top end in (say) the US (where 39 is prediabetic) whereas in the UK I believe 42 is prediabetic and in New Zealand you are prediabetic at 41.

 

[KennyA]

This is a handy graph that shows the distribution of HbA1c scores in a non-diabetic Dutch population. You'll see that the majority of people cluster in the 38-42 region.

 

[EllieM]

This is a handy graph that shows the distribution of HbA1c scores in a non-diabetic Dutch population. You'll see that the majority of people cluster in the 38-42 region.

Thanks @KennyA, am beginning to see why the US claim that so many of their population are prediabetic. It looks like the average on that graph is just 38 mmol/mol , which puts @Sophie123lou squarely in the middle .

 

[KennyA]

Thanks @KennyA, am beginning to see why the US claim that so many of their population are prediabetic. It looks like the average on that graph is just 38 mmol/mol , which puts @Sophie123lou squarely in the middle .

The US has history of shifting its definitions - they changed the definition of "obese" overnight in the 1970s IIRC and made it impossible to compare statistics over time.

I got my crayons out and added some colour which should make the graph a bit easier to read.

 

[Ronancastled]

Love that histogram @KennyA

A note on the study population from the data:
Average was age 55 with 45% being classed as overweight.

It's when we throw in the healthy 20 year olds that we skew the average A1c back closer to 5.2% (33).
You can see what decades of the standard western diet does to a population.

 

[Member34835]

Interesting study. I was surprised to see that a healthy range (as opposed to average described in the study ) is 21-37. Tallies with the US population where it seems on 12% of adults don't have some signs of insulin resistance!
In pregnancy there is a greater blood volume too though so this may mean the hba1c is 'diluted' and would be higher with normal blood volume or that's what my consultant told me when I was last pregnant 15 years ago.

 

[chrisjohnh]

Interesting study. I was surprised to see that a healthy range (as opposed to average described in the study ) is 21-37. Tallies with the US population where it seems on 12% of adults don't have some signs of insulin resistance!
In pregnancy there is a greater blood volume too though so this may mean the hba1c is 'diluted' and would be higher with normal blood volume or that's what my consultant told me when I was last pregnant 15 years ago.

So the summary is that it’s not healthy to be near the extremities of a “healthy” range, nor is it comforting to be in a normal cohort when that cohort is an unhealthy one.