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Question About Bloodwork


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  #1  
March 22nd, 2014, 08:01 AM
HalfDozen's Avatar Formerly Number5OnTheWay
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I just had my first midwife appointment this past Wednesday, and my blood pressure was a little high for me. They already have my chart flagged because I had PIH, which was not pre-e, with my 4th. So, she wasn't thrilled with the numbers, and I have to have it taken several times this weekend and report back next week to her. She also added a bunch of labwork onto my blood draw.
Yesterday, they called and said my glucose levels were elevated, and I need to meet with a nutritionist. When the nurse called, I was so shaken, that I didn't think to ask any questions, and I had to call back. The 2nd nurse that returned my call was not very kind, I didn't think, which I would have appreciated since this is all very new to me. Anyhow, she told me my A1C was 6.1. From everything I can find this is considered borderline and would be pre-diabetic, not diabetic, but the 2nd nurse told me that they are marking me as GD, but that I was likely diabetic before getting pregnant. Additionally, I am finding that low iron levels can falsely increase the A1C number. My iron was only 11 when it was tested a few weeks ago. I haven't seen the results of the bloodwork from this week yet.


Am I correct in demanding that I not be considered diabetic at this point? I also want to see the rest of my labwork to see where it falls. From what I can find, iron therapy is usually effective in lowering the A1C number, and I would rather try that first. Also, I'm not okay with automatically being forced to prick myself 4 times a day based on this one test. I have never had an issue in any prior pregnancies and have always passed all the GTT's with flying colors. I just feel like I am being forced into something that may or may not be accurate. If my A1C was 8, 10, or even upper 6's or low 7's, I would likely support their diagnosis of GD, but even the NIH says that anything below 6.5 is not considered diabetic.


Any advice???
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  #2  
March 24th, 2014, 01:51 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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First of all, I'm sorry your nurse was a *****. I think some medical staff forget that these are our lives and our babies, and just act like everything is a bad day at the office.

You are diabetic at 6.4 - when you are not pregnant. Remember, an A1c is a measurement of how you are doing over a three month period. It is not used to diagnose gestational diabetes in women not at risk, because it will not be in any way elevated when you get tested (24-27 weeks usually). If your A1c is 6.1, it means you have been experiencing elevated blood sugars for the past 2 or 3 months, or that there has been a very drastic change more recently.

If you are at 6.1 at just 9 weeks, you are going to be gestationally diabetic by the time they do your GTT. You have to act now. I'm going to tell you my story. I rarely share it with women with GD, because it can scare, but I share it with you now because you are in the perfect place to keep it from happening. I share this to empower you.

At 17 weeks I was in L&D for dizziness. My glucose was 256, so they ran an A1c. It was 6.9. Diabetic, but not too out of whack.

A week later, at 18 weeks on the dot, I was holding him in my arms. He had died during labor. The diabetes I didn't know I had had destroyed his developing kidneys. Because I didn't know until it was too late.

But, if we back up, to say 9 weeks . . . well, if I started the diet then, my son would have been fine. Even though at 9 weeks, I was soooo much more diabetic than you (it was type 2 diabetes, not early gestational), it didn't matter. My A1c would have likely looked like yours, and though you are not likely to get as sick as fast as I did, at the 9 week mark of my pregnancy, you and I would look the same.

You have information I didn't have - and you can use my story to empower yourself. You can derail this train. Your babies kidneys and other organs are perfect! And now you get to be a superhero and protect them. Yes, the diet is a PITA, but it's worth it. My second pregnancy I did the diet and even had an insulin pump (because I'm type 2, not gd) and it was really frustrating at times but this time, when I gave birth to my baby boy, I got to take him home.
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  #3  
March 24th, 2014, 02:44 PM
HalfDozen's Avatar Formerly Number5OnTheWay
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Thanks for the advice. We didn't even really discuss diet today because they only booked me for a short appointment. So, I got set up with the testing strips for 4x a day and then I have to bring those numbers to my next appointment. So far, the numbers are looking normal. I'm just not sure why my A1C is so out of whack. Any chance it's iron-deficiency related?
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  #4  
March 24th, 2014, 05:56 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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One study says yes, another says no. No large scale studies have been undertaken to assess this. And A1c is a ridiculous test to do in pregnancy anyway. It tells you how you've been doing, and because that changes so rapidly around the 24th week (or earlier if you have risk factors, which you do), how you were doing isn't terribly helpful, you want to know how you are doing now. I would ask your midwife for a fasting GTT. That will settle the matter pretty decisively. A1c's are just meaningless diagnostically when your body is changing every single day.
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  #5  
March 24th, 2014, 07:36 PM
HalfDozen's Avatar Formerly Number5OnTheWay
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Well, I've never had risk factors before...�� This test was the first indication.
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  #6  
March 24th, 2014, 09:09 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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PIH is a risk factor actually. Hypertension and glucose control functioning are annoying little BFFs.
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  #7  
March 25th, 2014, 01:29 PM
HalfDozen's Avatar Formerly Number5OnTheWay
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The PIH was with my 4th. My BP was only high at the office last week. I am pretty sure it was because I had been up since before 4 a.m. that day. It's been tested every day since then and been fine. And with my 4th, I had no odd tests for GD, either. It's all just so strange to me.
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