When working with people with T1DM, I use the hemoglobin A1c test for many purposes.
il It gives me a first indication of how well or poorly controlled a person's T1DM is when I first see her.
i It motivates the patient to try harder when the hemoglobin A1c is higher than the goal of 7 percent.
The difficulty with achieving a hemoglobin A1c of 7 percent or even 6.5 percent is the occurrence of hypoglycemia (see Chapter 4). The good news is that the longer the hemoglobin A1c is maintained at a normal value, the less hypoglycemia seems to be a problem.
i It clarifies the diabetic control when blood glucose measurements are up and down. A hemoglobin A1c of 7 percent, for example, means that most of the glucoses are in a satisfactory range, whereas a hemoglobin A1c of 8 percent means that they aren't. And if the glucoses aren't in a satisfactory range, the treatment should be revised.
i It permits me to encourage a woman with T1DM who wants to get pregnant to go ahead if the value is satisfactory or to tell her to wait if the level isn't right.
If a pregnant woman's hemoglobin A1c is high (over 8 percent for example), it mean's that her blood glucose was high on average at the time of conception of the baby. As a result, she's at high risk of delivering a baby with a congenital malformation. If she isn't yet pregnant, a measurement of the hemoglobin A1c tells her whether she can become pregnant now or should wait until her glucose is under better control. (See Chapter 16 for details on T1DM during pregnancy.)
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A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.