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pre conception targets

Discussion in 'Pregnancy' started by the_anticarb, Mar 10, 2012.

  1. the_anticarb

    the_anticarb · Well-Known Member

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    What is the official target hba1c for pre conception? I conceived accidentally last time so have never been in the position of trying to conceive!

    I'm under 7 at the mo but will they want it lower?

    I'm booked in to a pre conception clinic but it's taking three months for my appointment because they can only see x number of new patients per month so there's a waiting list.

    Not too happy about that, and don't want to wait to TTC if my hba1c is good enough, hence trying to get that info from here!

    Ta
     
  2. weeezer

    weeezer · Well-Known Member

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    NICE advises the following:


    The aim is to maintain HbA1c below 6.1% if that can be safely achieved. Any reduction towards 6.1% is likely to reduce the risk of congenital malformations.
    Women with HbA1c above 10% should be strongly advised to avoid pregnancy.
    As well as self-monitoring of blood glucose, HbA1c testing should be offered monthly.
    Discuss how diabetes affects pregnancy and how pregnancy affects diabetes, including:
    The role of diet, weight and exercise: women with diabetes who are planning to become pregnant and who have a body mass index >27 kg/m2, should be offered advice on how to lose weight (in accordance with the NICE obesity guidelines).11
    Risks of hypoglycaemia and its unawareness during pregnancy.
    Effects of nausea and vomiting on glycaemic control.
    Increased risk of having a large for gestational age baby and the possible complications of this (birth trauma, induction of labour, Caesarean section).
    Diabetic retinopathy and the importance of assessment for this before pregnancy. Retinal assessment should be offered at the first pre-conception appointment (if it has not taken place within the last 6 months).



    lifted the above from some medical site or other! 6.1%...pretty tight. mine was 6.8 in jan so hope i'm not too far off that. personally i think A1c's of 6 & below come with their fair share of hypo's so it all has to be considered.

    it also mentioned retinal assessment at preconception clinic. hope you get yr appt soon.

    haha as for bmi under 27, mine is 29! oops. i wish i got that last stone off & some extra, i can't afford to put 5 stone on AGAIN! how can this be avoided with the ridiculous amount of insulin that goes in tho? a pump? will be begging for one...!
     
  3. the_anticarb

    the_anticarb · Well-Known Member

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    hi Weezer, my bmi has only just got under 27 after gaining 4 stone in my previous pregnancy - yes insulin is to blame, so the ONLY way to get round this is to low carb i'm afraid.
    Interesting that they say hba1c>10 = avoid pregnancy as i was not far off ten when i conceived Zac, he must be one miracle baby to be conceived not only by accident but with my bloods so high, and then not miscarry/malform - apart from being slightly on the small side when born, which could have been due to being taken out at 38 weeks when he wasn't quite ready, he was and is in absolutely perfect health with not a thing wrong with him.

    My appointment is for 16th April, so three months to the day since my referral, but my hba1c is ok and my gp gave me the folic acid and said I was ok to start to TTC so i'm not going to let it stop me. Having another hba1c test this week so fingers x'd it'll have come down a bit more with the low carbing - again the only way to get it low without hypos is low carbing, pretty boring diet-wise but it's that or be a hypoing fatty, i'm afraid.

    Retinas wise i'm being seen by the eye hospital every four months so not much more the antenatal will do I don't think.
    Rubbish that they make diabetic ladies go on a waiting list for preconception, you wouldn't have thought there'd be too many of us either as most diabetics are t2 and over 40, but hey won't be long now til my appointment.
     
  4. the_anticarb

    the_anticarb · Well-Known Member

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    update - conceiving put on hold whilst they sort out the retinopathy in my left eye. Hopefully I'll be good to go again in another 4-6 months. Any ladies with pre existing diabetes and retinopathy, no matter how mild, please don't think of ttc until you've had your eyes checked. you'll probably be fine but any problems and they may want to stabilise before you go ahead and conceive. They can treat retinopathy during pregnancy, but it is harder due to the growth hormones which hinder the treatment.
     
  5. Nicklenocky

    Nicklenocky · Well-Known Member

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    Hi Anticarb

    Interesting to read your last experience and how you concieved with a HBA1C above 10. I am now 20 weeks and conceived accidently at 8.2...I cant tell you how much this is haunting me and so I was happy to read your positive experience.

    A question for both of you ladies anticarb and weezer....with your last pregnancies did your doctors put you on a daily dose of aspirin for pre-eclampsia? I live in the Middle East and so they may advise different things here, my diabetes doctor wants me to take aspirin every day as all of his pregnant type 1 patients have done. Have you heard of this before?

    Would be great to have your feedback.
     
  6. weeezer

    weeezer · Well-Known Member

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    nicklenocky - it's haunting me too that i wasn't aware i was pregnant for a couple of weeks so the first 4 weeks of growth had a few double figure spikes. have you had the fetal anomaly scan where they look at the heart etc? last time i was on the edge of me seat until the scan, it was very reassuring.

    no, never heard of aspirin...are we more pre-disposed to pre-eclampsia? had to stay i hosp all day coz of high blood pressure once last time, but it was fine after that. i don't know that high bp is always linked to pre-eclampsia in pregnancy? if i'd been advised that aspirin helped to ward it off i would've taken it. will be asking when i eventually get to an ante-natal clinic and let you know what they say over ere!

    how ya feeling at 20 wks?
     
  7. Nicklenocky

    Nicklenocky · Well-Known Member

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    Hi weezer

    Yes, it seems us type 1s are pre-disposed to everything, pre-eclampsia being one of them. I will do some more research regarding the aspirin.

    I have my big scan on the 31st march, can't wait to have it and hope it brings me some reassurance.

    At 20 weeks I am feeling good, got my energy back, cravings have settled but I am starting to feel heavier now, getting sausage fingers, puffy cheeks and out of breath! My belly has also popped out now so there is no mistaking I am pregnant now!
     
  8. BeccaJaneStClair

    BeccaJaneStClair · Well-Known Member

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    BMI under 27?! I'll never be able to conceive at this point.....
     
  9. shop

    shop · Well-Known Member

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    I wasnt diabetic when I had my son.

    I do think its bad that you have to wait to attend a pre conception clinic. ( I am not planning on having anymore ) However whenever I go to the hospital they always tell me that there is a pre conception clinic every Friday! Doesn't even sound like you need to make an appt.

    Anyway hope you get the help and support that you deserve and go on to have a lovely baby and keep well yourself

    Lucy xxx
     
  10. Devidmomin9

    Devidmomin9 · Newbie

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    Very good information, thanks for sharing with us and hope that you always provide me such type of information.
     
  11. BeccaJaneStClair

    BeccaJaneStClair · Well-Known Member

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    I see the preconception clinic on the 27th, I'll report back what I get told then!
     
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