Pregnancy complicated by diabetes: what is the best level of HbA1c for conception?

To reduce the congenital malformations that occur in pregnancies complicated by diabetes, it is essential to achieve and maintain a good metabolic control before conception. In this context, measuring HbA1c is considered as the gold standard for monitoring metabolic control in diabetes and various d...

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Bibliographic Details
Published in:Acta diabetologica 2010-09, Vol.47 (3), p.187-192
Main Authors: Lapolla, Annunziata, Dalfrà, Maria Grazia, Fedele, Domenico
Format: Article
Language:English
Subjects:
Blood tests
Congenital diseases
Diabetes
Diabetes Mellitus - blood
Diabetes Mellitus - drug therapy
Diabetes Mellitus - physiopathology
Female
Fertilization - physiology
Glycated Hemoglobin A - analysis
Glycated Hemoglobin A - metabolism
Humans
Hypoglycemia - blood
Hypoglycemia - complications
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Metabolism
Models, Biological
Obstetrics
Pregnancy
Pregnancy in Diabetics - blood
Pregnancy in Diabetics - drug therapy
Pregnancy Outcome
Review Article
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Summary:To reduce the congenital malformations that occur in pregnancies complicated by diabetes, it is essential to achieve and maintain a good metabolic control before conception. In this context, measuring HbA1c is considered as the gold standard for monitoring metabolic control in diabetes and various different HbA1c levels have been recommended as optimal in the preconception period for diabetic women planning a pregnancy. An analysis of key studies published on this issue until now clearly shows that HbA1c levels correlate closely with the occurrence of congenital malformations and other neonatal complications characteristic of pregnant diabetic women. HbA1c is therefore one of the key markers to use in monitoring metabolic control, and the most reasonable approach would seem to be to use a standardized measurement method and aim for HbA1c levels resembling normal values as closely as possible, with a view to preventing episodes of hypoglycemia.
ISSN:0940-5429
1432-5233
DOI:10.1007/s00592-010-0199-z