High-Risk Pregnancy
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Confusion about GD and A1C and Fructosamine levels

Okay, so my OB diagnosed me with GD due to failing my 1hr glucose test.  I was sent to see an endocrinologist who tested my sugar level and it was slightly elevated.  They then ordered bloodwork.  My A1C is 5.6 (which is consistent with absence of diabetes), and my Fructosamine level was 172 (normal is 190-270).  I have been on Metformin for about 9mos now due to PCOS and a "borderline" A1C with my initial paperwork (it was 5.7 then).  Am I being classified as having GD because my level is 5.6 on the Metformin?  My fasting BGL is always between 100-110, and my daily levels are always under 130 an hour after a meal.  Have any of you ladies dealt with this?  I am trying very hard to not get put on insulin, I eat less that 20g of carbs each meal, and less than 15g at snacks.  What am I doing that is making my fasting numbers higher than my endo likes?  Why are my A1C and Fructosamine levels not reflecting the high fasting numbers?

I have an appointment with OB tomorrow and one with my endo on Tuesday, but I'm looking for information I can use to discuss this with them. 



Cody Lane - 4/22/2004
Colten James - 9/9/2005

Isabella Ann - 7/20/2012

SURPRISE!!!  Emma Leigh - due 8/27/2015 (c-section date 8/7/2015)

BabyFruit Ticker

Re: Confusion about GD and A1C and Fructosamine levels

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    I was told I have GD after failing one value on 3 hour test. My a1c is similar to yours, and I took test early because of the a1c. I questioned the diagnosis, because the lab report says right on it that you have GD if you fail 2 values. The dietician explained that insulin needs triple during pregnancy, and if I failed one value at 16w I would probably fail 2 values at 25-26w when the test is usually done. No experience with the fructosamine level, as I've never had mine tested. The Dietician said, they'd rather monitor you if there is any suspicion of GD. My blood sugar values, like yours, are well controlled with diet.
    TTC since 10/09 Me-43 DH-44 RE and testing 10/10-11/10, Recommending IVF 1/11 New RE AMA and DOR-DH low motility IVF #1.1 cancelled 3/11 due to poor response IVF #1.2 May 2011, one perfect 8-cell embryo, 3dt-BFN, IVF #2.1 Converted to IUI d/t poor response. New RE 9/2011. IVF 2.2 completed using HGH,EPP,DHEA, Q-10 and accupuncture. Transferred one 8-cell, grade one embryo on 10/19. BFP 10/31/11 Chemical pregancy on 11/2/11. Started stims for IVF #3, our final try, on 12-2-11. ET on 12/18. Transferred 3 Grade A embryos-BFFN Planning DE IVF, late March/early April- Donors ER expected to be 4/2-4/4. PAIF/SAIF welcome
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    I'm not sure why they tested my fructosamine level (I'm assuming because I'm newly diagnosed and it measures the last 3wks), but I am hopeful I will get some more answers tomorrow and Tuesday.  The endo I went to previously said that my fasting sugars were way too high and that it would require I took insulin.  I'm hoping the new Endo disagrees! 



    Cody Lane - 4/22/2004
    Colten James - 9/9/2005

    Isabella Ann - 7/20/2012

    SURPRISE!!!  Emma Leigh - due 8/27/2015 (c-section date 8/7/2015)

    BabyFruit Ticker
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    tpete12tpete12 member
    I have been Type 1 Diabetic for many years now. My last A1C was 6.1 and my doctor was okay with that. Your daily numbers are running a little higher than they should be (4-7 is normal). My guess is that your sugars haven't been elevated for long enough to affect your A1C because is a 3 month average of your blood sugar levels. Without treatment, my guess is that your next A1C would be higher. Good luck and hopefully your A1C stays where it is at!
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    The way it was explained to me, is the high fasting numbers are your pancreas just not being able to keep up and there is nothing you can do in order to make those better through diet and exercise (that was very frustrating to me too).  Also, the baby is now dumping all kinds of extra sugars into your bloodstream which will increase as baby gets bigger.  Sadly, there may not be a way to avoid insulin, but at least you will be doing what is best for baby.
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