Diabetes and fertility
I am 34 years old and trying to conceive. I am diagnosed as having type 2 diabetes. My doctor has been monitoring my blood levels of HbA1c which is 9.6 % at present. He told me I should wait a while till the levels drop to 6.5% or lower before I try to get pregnant. Why should it be so? What is HbA1c? What does the percentage represent?
Keeping the blood sugar levels under control is very important for diabetic patients who are trying to conceive. This is because uncontrolled diabetes during pregnancy may have serious consequences affecting the baby such as miscarriage, premature birth, stillbirth and having a big baby requiring Caesarean section. When sugar is absorbed into the body from the food, it is circulated in the bloodstream as glucose .
A certain amount of glucose gets attached to the haemoglobin, a protein in the red blood cell that carries oxygen. The compound formed is called “glycated” haemoglobin or HbA1c. The amount attached is directly proportional to the total amount of blood glucose present in the body and is expressed as a percentage of the total haemoglobin.
As the life span of the red blood cells is 8-12 weeks, measurement of HbA1c is used to assess the average blood glucose levels over that duration. This provides a useful gauge of blood sugar control in diabetic patient. In healthy people, the HbA1c level is less than 6% of total haemoglobin. Your level of 9.5% is high and indicates that your diabetes is not well controlled.
Studies have demonstrated that the complications of diabetes can be reduced or prevented if the HbA1c level can be kept below 6.5%. Since you are planning to become pregnant, you should be monitored with HbA1c monthly to help monitor your diabetes control.
Meeting the target of 6.5% or below will help minimise the risk of the baby developing congenital malformations or other complications during pregnancy. As your level of HbA1c still high, you are advised to avoid becoming pregnant until good diabetes control is achieved and sustained.