Could anyone kindly share their perspective? I’ve spoken with my physician and feel a bit better, but I’m still worried I messed up. This is my third pregnancy and my third time dealing with GD. I failed an early glucose screen at 14 weeks and have been sticking to the GD routine since. I’ve had blood drawn at every single visit so far. I really dislike needles; I manage, but it’s definitely unpleasant. My first visit was baseline labs, then the NIPT, then an early GTT, and then a quad screen. I already knew more blood work was scheduled for my next visit too. At my 24-week appointment, I was hoping for a quick visit without needles. Instead, a nurse scolded me for not visiting the lab first. I got there 20 minutes early, and nobody mentioned labs when I checked in or had my vitals taken. No one informed me about any tests. It turned out to be an A1C test requested by a different doctor previously. I thought A1C wasn’t very reliable this far into pregnancy? When I asked, my primary doctor immediately said it wasn’t mandatory and canceled the order, noting that different doctors have different preferences. Was that test actually important? Between my needle phobia, the surprise request, and being reprimanded, I just reacted. Plus, I received some difficult news during that same visit—a referral to MFM for a possible heart issue, talk of early delivery, a different hospital, and NICU care. I was incredibly stressed. I just feel like I’m always failing at this.
I’m not a medical professional, but I also heard that A1C isn’t particularly useful while pregnant, particularly if a GD diagnosis is already confirmed and being managed. My A1C was only checked once during my three-hour glucose test. It was within range then and actually lower than my current postpartum levels, as pregnancy can skew the results downward. My medical team didn’t seem concerned with it; it was just standard procedure. I didn’t have another one until 3 months after giving birth. I believe you were right to skip it. You’re dealing with enough right now!
Having had my A1C monitored twice during my pregnancy and being someone who also hates needles, I don’t think it’s essential or very precise. I only went along with it because they were already drawing blood for other things, so adding one more test didn’t change much for me.
Are you tracking your glucose levels right now?
My A1C was checked several times. Even though it’s not perfectly accurate because of increased blood volume, they adjusted the target ranges. For non-pregnant people, the goal is under 42, but I was told for pregnancy it’s 35 (mmol/mol). They used it to monitor my overall trends to ensure my levels weren’t staying high. I did this alongside testing my blood sugar four times a day because my baby’s abdominal circumference was in a high percentile, even though my daily readings were fine; they wanted to see if I was spiking at other times. Ultimately, it’s about what you and your physician decide. If it were crucial, they would have insisted on it. Don’t feel bad! *I’m not a doctor, just sharing what I was told, and I know medical advice can vary!
I was informed that an A1C check during a GD diagnosis helps determine if it’s standard gestational diabetes (starting around 24-28 weeks and usually resolving after birth) or if it’s actually undiagnosed Type 2 diabetes. While they can’t give a definitive Type 2 diagnosis during pregnancy, a high A1C at 24 weeks is a strong indicator. However, the A1C result doesn’t actually change how you manage your blood sugar while pregnant, so declining it isn’t a huge issue. It just means you have slightly less information regarding whether the diabetes will persist after delivery.