Women with type 1 diabetes should keep their blood glucose levels well controlled before they get pregnant, in order to minimise the risk of adverse pregnancy outcomes.
Women with type 1 diabetes should keep their blood glucose levels well controlled before they get pregnant, in order to minimise the risk of adverse pregnancy outcomes.
Blood measurement known as HbA1c (glycosylated haemoglobin) is an indicator of how well glucose levels are kept in the normal range over the long term. To study the association between peri-conceptional HbA1c and serious adverse pregnancy outcome, researchers looked at 933 American women with diabetes who were having their first baby.
Forty-five babies were born with birth defects, including 23 that were major, and 31 infants died before or soon after delivery, of which 5 involved major malformations.
It was found that the risk of serious adverse outcomes increased gradually with levels of HbA1c above 6.9% and doubled when it reached 10.3%; at HbA1c readings of 10.4% or greater, the risk quadrupled.
The above results support a recommendation of preconceptional HbA1c levels less than 7% in women with type 1 diabetes, emphasising the importance of blood sugar control and pre-pregnancy counselling.
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