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HBA1C in pregnancy

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joannaharvey7

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Gestational
I was diagnosed with gestational diabetes but my nurse is concerned I may actually be type 2.
I have reason to believe that my pregnancy hormones and naughty pregnancy diet (which I've since massively changed) are the reason for my high GTT test.
Anyhow. My nurse insisted on a HBA1C test which came back as 50. She then proceeded to diagnose me as Type 2 until proven otherwise post pregnancy.
But I've just read on here that the HBA1C should not be an indicator of diabetes while pregnant. I'm 7 months now so the results over last 12 weeks which would have been picked up would all have been while I'm pregnant.
Has anyone got any advice or can back up/confirm that the nurse should not have performed the HBA1C whilst I was still pregnant for diagnosis reasons? Thanks!
 
Hello Joanna,
Congratulations with your pregnancy.
First off I'd say that the nurse is not qualified to diagnose you. The hba1c test would *obviously* come back slightly raised as you said yourself that you have GD so I'm not sure what she was trying to achieve by making you do the test. The important thing for now is that you receive support for how to best control your BGs, so if you feel you need support then please ask your team !
In terms of T2 / GD etc - as far as I know some women get tested a few week post partum and diagnosis is made based on these results . Good luck
 
Thanks for your response. I've actually booked a second opinion appointment with my GP.
my diabetes nurse says she has been so for 20 years and was a midwife for 12. So I'd hope she would know better! My GTT results were very high so I can see her concern but it can't have been a long term high as my A1C would surely have been much higher?
She also put me straight on metformin and insulin before each meal and before bed.. but my before lunch readings have been going between 3.8 and 4.3 which is quite low I believe (apart from today which was 5.5 as I snacked a lot due to previous lower readings worrying me).
 
Getting a second opinion Sounds like a good plan ! Given that she's put you on insulin has she talked to you about hypo awareness? I was diagnosed aged 19 and had my babies at 37 and 39 , so I'd had my fair share of hypos before pregnancy but pregnancy hormones do make your hypo awareness worse,
So you don't spot them as early as you normally would. I used jelly babies to treat . X
 
My GP confirmed that the blood test should not have been used while pregnant to diagnose T2.
He believes this to be gestational so I've no need to go for the retinol screen as yet which made me very relieved!!
He sees the nurses point - my GTT was high enough to be T2 but as I'm pregnant we can't know for sure. Since being on 2 units of insulin per meal (8 before bed) my BG is rarely going over 7 post meal now and always below 5 each morning (usually 4.6/4.7).
 
Well considering the third trimester, which you're now smack in the middle of, is the one where everyone is MEGA insulin resistant (Type 1s might work up to use as much as THREE times the insulin than when they're not preg!) and you're still on such a little bit of insulin and it's keeping you steady - frankly I wouldn't worry too much.

Do they let you go full term with GD ?
 
I thought it was quite a little amount so I'm pleased. I'm on 8 before bed so not sure how good or bad that is.
I'll find out more tomorrow after my growth scan about potential induction. I think it'll all depend on my readings and how the baby is doing x
 
I'm T1 and not huge, and the max 'background' insulin I was on was 18u. Typically T2s use masses more than T1s because so many T2s also have insulin resistance.

So no way Conchita, are you 'already' T2 !!!
 
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