GD with low A1C and Fructosamine levels

chavemann10

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, as I am completely confused and Google is sending me in circles. 

I also posted this on the High-risk board to see if any of the ladies over there may have some advice. 

jessandandy09

My understanding is that the 1 hour glucose test is almost always wrong.  Many OBGYN's are skipping it all together and doing a 2 or 3 hour test right off of the bat.  I am not a doctor so I don't want to guess about your health, but people I have helped at work to maintain a healthy lifestyle (for the people with diabetes) do what you are doing.  

Could you ask for the 3 hour test before you are given a "diagnosis"?

chavemann10

jessandandy09 said:

My understanding is that the 1 hour glucose test is almost always wrong.  Many OBGYN's are skipping it all together and doing a 2 or 3 hour test right off of the bat.  I am not a doctor so I don't want to guess about your health, but people I have helped at work to maintain a healthy lifestyle (for the people with diabetes) do what you are doing.  

Could you ask for the 3 hour test before you are given a "diagnosis"?

I plan on asking for it tomorrow or next week.  I want it done!  I do see my BGL elevated in the morning though, so I understand it's plausible, but I just don't understand why my other numbers are not reflecting this at all. 

Saratiff

So your A1C level is great they like to see anything less than 7! Which is awesome because that is reflective of your blood glucose levels on average for the last three months. I am a cardiac nurse not OBGYN, labor and delivery or diabetes so don't take me to the grave on this but it is my understanding is that while all your numbers are great from a type 2 diabetic index ( which is all I have experience with and would not require Insulin) those are two different diagnosis unfortunately. I think there is a different scale for the fasting blood glucose levels when you are pregnant and I think the scale is tighter. But I'm not sure exactly.

In any case Endo and ONgYn will be able to give you all the information and I would love to be kept in the loop of what they say. I will be sending lots and lots of good vibes your way :-) good luck

chavemann10

@Saratiff,  Thank you!  I have been googling it all morning and either I'm not seeing it, or I just can't find what the requirements are for pregnancy.  My endo said my goal was >90 fasting and >130 1hr after meals.  I meet the requirement for the after meal, but not the fasting.  I'm not sure why it's always higher than it should be and why it's not reflecting in my bloodwork.  I'm hoping they have more answers for me, but this is going to drive me crazy until I see them.  LOL

jesselayne8

It takes months of high glucose levels for your A1C to increase. If you recently developed GD then it would not affect your A1C yet. Hopefully a good A1C indicates that your levels should return to normal after pregnancy and you will not develop type 2 diabetes. I sounds like your GD will probably be managable with diet alone and you won't have a need for insulin. I agree with the other ladies about requesting a 3hr test.

acgonzalez22

I had failed the 1 hr and 3 hr before being diagnosed, as well as had labwork done? I too have PCOS and GD. I eat between 30 to 45g for meals and 15 to 20g for snacks. I have been following a nutritionist's meal plan for 6 weeks now and my fasting and after meal levels have been perfect. The difference however, is my A1C was an 8. Also with each glucose test my blood draws were in the 200's! So I definitely have GD. I don't take any medication and will not need to as long as my diet is controlled. I never took medicine for my PCOS either. We went straight to fertility treatments due to other issues. Keep us posted as I would like to know what the doctors say. Hang in there. I honestly have never felt better!

chavemann10

acgonzalez22 said:

I had failed the 1 hr and 3 hr before being diagnosed, as well as had labwork done? I too have PCOS and GD. I eat between 30 to 45g for meals and 15 to 20g for snacks. I have been following a nutritionist's meal plan for 6 weeks now and my fasting and after meal levels have been perfect. The difference however, is my A1C was an 8. Also with each glucose test my blood draws were in the 200's! So I definitely have GD. I don't take any medication and will not need to as long as my diet is controlled. I never took medicine for my PCOS either. We went straight to fertility treatments due to other issues. Keep us posted as I would like to know what the doctors say. Hang in there. I honestly have never felt better!

Can you send your feel good this way? I have felt so out of it since starting this low carb/low sugar stuff.  I miss my old self, the one who had energy, could sleep, could poop, could do anything.  This new me is sluggish, tired all the time, but has insomnia and lord only knows when a bm will happen.  LOL!!  I wasn't on the Metformin necessarily for being pre-diabetic, more because we had run out of other medications to take to help regulate my periods...

acgonzalez22

I am so sorry you feel that way. I am the complete opposite. I have great BM's finally from fiber rich foods. I have more energy from healthy proteins. Maybe you should speak to your doctor about how you are feeling? Or see a nutritionist? I exercise every day and sleep much better than before. Pls PM me if you need to chat.

kedbach

A1c is a 3 month average of your sugars. I'm assuming they're classifying you as GD, because like you said, on the meds your sugars are higher than what they like. I've been diabetic since 12, so the whole diabetes/pregnancy thing together is frustrating, especially when looking at normal ranges, you're in them! My Endo wanted my fasting sugars to be <70 and post-meal to be <115, which telling this to a diabetic seeks nuts, as normal ranges that they're happy with are topically 80-150, anything below 70 is when I get shaky and need to eat. I thought she was crazy, but hearing you say this, makes me think that it's just how tight they want your numbers to be while pregnant. I hope they can answer all of your questions as to why you're on meds still and what else you can do, because to me, it seems like you're doing so well!!!

jessandandy09

make sure to update us when you find out more.  I am super curious and hope everything works out for you!

chavemann10

I will be sure to post as soon as I leave the doctors office.  I woke up this morning with another issue, so I don't plan on getting out of there without a long visit today...LOL

kedbach

Wow excuse my terrible autocorrects-- I hate the mobile app! I promise I use proper grammar.

Saratiff

@kedbach happens to me all the time :-)