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Hba1c 5.7 During Pregnancy

Normal Blood Sugars In Pregnancy

Normal Blood Sugars In Pregnancy

I have until now avoided discussing the issue of what normal blood sugars should be in pregnancy because it looked like gynecologists were being more aggressive with blood sugar control during pregnancy then other doctors. Blood sugar control is particularly important in pregnancy because a fetus that is exposed to continually high blood sugars will experience significant changes in the way that its genes express which will affect its blood sugar metabolism for the rest of its life. High blood sugar will also make babies very large, which poses problems when it is time for delivery, some life-threatening. Blood sugars are lower in pregnant women because there is a higher blood volume during pregnancy, but it is starting to look like the targets gynecologists have been recommending, which would have been excellent for non-diabetic women are considerably higher than normal. This was made clear by a new meta-study that analyzed a series of studies of the blood sugars of a wide range of normal pregnant women using Continuous Glucose Monitoring, home testing, and hospital lab results. It makes it clear that the current targets for pregnancy are probably too high. Here is the full text version of the meta-study: Patterns of Glycemia in Normal Pregnancy: Should the current therapeutic targets be challenged? Teri L. Hernandez, et al. Diabetes Care July 2011 vol. 34 no. 7 1660-1668. It concludes that the following appear to be truly normal blood sugars for pregnant women: AVERAGE BLOOD SUGARS IN NORMAL PREGNANT WOMEN Fasting: 70.9 ± 7.8 mg/dl (3.94 mmol/L ± .43) One Hour Post Meal: 108.9 ± 12.9 mg/dl (6.05 ± .72 mmol/L) Two Hours Post Meal: 99.3 ±10.2 mg/dl (5.52 ± .57 mmol/L ) A commentary published in this month's Diabetes Care gives more insight into the importance of t Continue reading >>

What Should My Hemoglobin A1c Levels Be If I'm Pregnant And Have Diabetes?

What Should My Hemoglobin A1c Levels Be If I'm Pregnant And Have Diabetes?

If you have diabetes and are pregnant your A1C levels should be as close to normal as possible. Pregnant women who do not have diabetes typically have A1C levels of less than 5%, and this should be the target range for pregnant women with diabetes. The A1C test measures the percentage of glycated hemoglobin in your blood. Glycated hemoglobin is created when molecules of hemoglobin (the oxygen-carrying protein in your blood) attach to molecules of glucose (the sugar in your blood). The more sugar you have in your blood, the higher your percentage of glycated hemoglobin. The American Diabetes Association recommends a target number of 4% to 6%. The American College of Obstetrics and Gynecology recommends a target number of no higher than 6%. Talk to your doctor about the best ways to manage your blood sugar levels during pregnancy. An A1C (Hemoglobin A1C) is a blood test that can predict average blood glucose levels for about 8-12 weeks. Women with diabetes should strive for "near normal" A1Cs prior to, as well as during, pregnancy. In general the target A1C should be less than 7% before pregnancy and less than 6% while pregnant. Continue reading >>

Diagnosis

Diagnosis

Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>

A1c Levels And Miscarriage?

A1c Levels And Miscarriage?

Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Hi All - I'm new to this board so I apologize if this is information that has been covered already. I have had 2 m/c in the past 10 months. My most recent was last week and I am still dealing with that. I have not been diagnosed as diabetic, though I did have gestational diabetes during my first pregnancy (which resulted in a healthy baby boy). I asked my doctor last week why this might happen twice in a row and other than genetic issues, she suggested that my blood sugar might be an issue. I had an A1C done about 2 weeks prior to last week's appt. and it was 5.7. I'm reading that shooting for an A1C of 6 or less is pretty good and safe for conception. I am trying to learn if that is indeed the case or if maybe it could have been a blood sugar issue and I need to really work on that before I try to get pregnant again. Welcome to the forum. How far along was the pregnancy prior to m/c? I am truly sorry for your loss, such news is never easy. With an A1C of 5.7 it's really unlikely that was the specific cause. I have heard about women with thyroid issues suffering from multiple miscarriages but with proper medication this likelihood can decrease. Do you have a family history of thyroid issues? Some people aren't even aware their thyroid is an issue until the hormones are raging. Wishing you the best of luck and sorry I can't offer more concrete answers. Thank you. This time the baby measured 9 weeks and 2 days when it stopped growing. I found out at the 11 week ultrasound. (The first m/c was much, much earlier). I actually had my thyroid checked like 2 weeks into the pregnancy because I was col Continue reading >>

Associations Of Mid-pregnancy Hba1c With Gestational Diabetes And Risk Of Adverse Pregnancy Outcomes In High-risk Taiwanese Women

Associations Of Mid-pregnancy Hba1c With Gestational Diabetes And Risk Of Adverse Pregnancy Outcomes In High-risk Taiwanese Women

Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women 1Department of Endocrinology and Metabolism, Kuang Tien General Hospital, Taichung, Taiwan 4Department of Food and Nutrition, Providence University, Taichung City, Taiwan 3Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan 5Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan 6Department of Nutrition and Institute of Biomedical Nutrition, Hung Kuang University, Taichung, Taiwan 3Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan 6Department of Nutrition and Institute of Biomedical Nutrition, Hung Kuang University, Taichung, Taiwan 7Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan 1Department of Endocrinology and Metabolism, Kuang Tien General Hospital, Taichung, Taiwan 2Department of Obstetrics and Gynecology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan 3Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan 4Department of Food and Nutrition, Providence University, Taichung City, Taiwan 5Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan 6Department of Nutrition and Institute of Biomedical Nutrition, Hung Kuang University, Taichung, Taiwan 7Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan University of North Carolina at Chapel Hill, UNITED STATES Competing Interests: The authors have declared that no competing interests exist. Received 2016 Dec 7; Accepted 2017 Apr 28. This is an open access article distributed under the terms of the Creative Com Continue reading >>

What Was Your Hba1c Result While Pregnant?

What Was Your Hba1c Result While Pregnant?

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community What was your Hba1c result while pregnant? Discussion in ' Pregnancy ' started by Mrsass , Sep 21, 2014 . Just wondering what people's range was when pregnant obviously I know the lower the better n what numbers your bg needs to but but just wondered what your a1c was, my first result since I started planning was 51 which I got last week and that's the lowest I've had it in a LONG time so really pleased with myself In my first pregnancy it ranged from 5.3-6. Second pregnancy it's been 5.7 since a couple of months before getting pregnant until now at 8 weeks. Well done for getting yours so low your doing really well. There's no better incentive than pregnancy! Hi, mine was 6.4 pre-pregnancy (I still do old system I'm afraid), 5.4 in 1st trimester and at 17 weeks 5.6... Am hoping I can keep it around that for the rest! Im not pregnant yet but my docs at pre conception said they would ideally like my hbac1 to be 6.5 before I start trying but said they would give me the green light if it was anything under 7! xxx Hello! For the months before conception mine was about 6.7. Once pregnant (just after Xmas time...) it was about 7.2 or a touch lower for the first trimester, and then from 2nd trimester onwards it gradually dropped from 6.8 to 6.0. Know mine were higher at times than what a lot of others manage and I stressed a lot about it especially in the beginning but the endo team were fine with them. To me it felt the preconception numbers were really the ones they were most vigilant about. Good luck! (Baby entered world totally healthy and definitely not macrosomic so we had no diabetes related complications with those numbers) During the months before co Continue reading >>

Hba1c Levels Are Significantly Lower In Early And Late Pregnancy

Hba1c Levels Are Significantly Lower In Early And Late Pregnancy

Strict glycemic control is essential to minimize the maternal and fetal morbidity and mortality of pregnancies complicated by diabetes (1–3). In addition to home blood glucose measurement, which may not always reflect the true average blood glucose level (4), HbA1c is a useful parameter in metabolic regulation (5–8). Thus, supplementation with HbA1c, as is common outside pregnancy, seems appropriate. Before pregnancy, the target for metabolic control in women with diabetes is HbA1c values near the normal range (9). However, the upper normal range of HbA1c during normal pregnancy is only sparsely investigated with different methods (10), mainly in late pregnancy (5,6,11,12), and reference ranges are generally established from the nonpregnant state (4). Increased third-trimester HbA1c levels are associated with an increased risk of preeclampsia (3,13), macrosomia (1), and stillbirth (2), leading to speculations that the target for HbA1c in pregnancy should be even lower than outside pregnancy to prevent adverse events. There is a need to establish the reference range of HbA1c during normal pregnancy with an internationally recognized Diabetes Control and Complications Trial (DCCT)-aligned method. In this study, we evaluated the normal upper range of HbA1c in early and late pregnancy. RESEARCH DESIGN AND METHODS From our antenatal clinic, we randomly selected 100 healthy pregnant women without previous gestational diabetes (early pregnancy group). All subjects had a random capillary blood glucose level <7.0 mmol/l at their first antenatal visit at approximately week 14 (range 8–17), and none developed gestational diabetes. A selective screening based on risk factors for gestational diabetes was used (14). A late pregnancy group was established of 98 h Continue reading >>

Original Research Hba1c As A Predictor Of Diabetes After Gestational Diabetes Mellitus

Original Research Hba1c As A Predictor Of Diabetes After Gestational Diabetes Mellitus

Highlights • Third-trimester HbA1c was investigated as a predictor of diabetes following GDM. • After five years, 73/196 (37%) of the women had developed diabetes. • HbA1c ≥36 mmol/mol (≥5.4%) was associated with a 5.5-fold increased risk of diabetes. • HbA1c showed high specificity but low sensitivity to predict diabetes post-partum. • HbA1c could be used as a means of selecting high-risk women for interventions. Abstract We wanted to investigate third-trimester HbA1c as a predictor of diabetes after gestational diabetes mellitus (GDM). Women with GDM were followed up prospectively for five years from pregnancy to detect the development of diabetes. The ability of HbA1c to predict diabetes was evaluated with receiver-operating characteristic (ROC) curves and logistic regression analysis. By five years, 73 of 196 women had been diagnosed with diabetes. An optimal cut-off point for HbA1c of 36 mmol/mol (5.4%) could predict diabetes with 45% sensitivity and 92% specificity. For HbA1c ≥39 mmol/mol (≥5.7%), sensitivity, specificity, and positive predictive value were 30%, 97%, and 91%, respectively. In logistic regression analysis, adjusting for the diagnostic glucose concentration during pregnancy, HbA1c levels in the upper quartile (≥36 mmol/mol) were associated with a 5.5-fold increased risk of diabetes. Third-trimester HbA1c levels in the pre-diabetes range revealed women with post-partum diabetes with high specificity and high positive predictive value. HbA1c testing could be used as a strategy to select high-risk women for lifestyle interventions aimed at prevention of diabetes starting during pregnancy. The results should encourage further validation in other populations using new diagnostic criteria for GDM. Continue reading >>

Hemoglobin A1c (hba1c) Test For Diabetes

Hemoglobin A1c (hba1c) Test For Diabetes

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes. Hemoglobin is a protein found in red blood cells. It gives blood its red color, and it’s job is to carry oxygen throughout your body. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher change of getting of diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year. People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can Continue reading >>

Research Paper Role Of Hba1c In Post-partum Screening Of Women With Gestational Diabetes Mellitus

Research Paper Role Of Hba1c In Post-partum Screening Of Women With Gestational Diabetes Mellitus

Highlights • We compare the performance of HbA1c with established glucose criteria during an oral glucose tolerance test (OGTT). • We also assess HbA1c as a screening test for undiagnosed diabetes and pre-diabetes after gestational diabetes mellitus. • Proposed thresholds of HbA1c had low diagnostic sensitivity relative to OGTT. • Combining HbA1c with a fasting glucose test the performance was no better than using a fasting glucose test alone. • Combining a fasting glucose test with a lower HbA1c cut-point may be an option for selection of women for an OGTT. Abstract To compare the performance of HbA1c with established glucose criteria during an oral glucose tolerance test (OGTT) and to assess HbA1c as a screening test for undiagnosed diabetes and pre-diabetes after gestational diabetes mellitus (GDM). Glucose homeostasis was re-evaluated 1–5 years after delivery in 140 women with previous GDM, by means of OGTT and simultaneous HbA1c measurement. Glucose tolerance was defined according to World Health Organisation criteria. HbA1c ≥6.5% (≥48 mmol/mol) was used for diabetes diagnosis and HbA1c ≥5.7% (≥39 mmol/mol) to define abnormal glucose homeostasis. HbA1c had low sensitivity (14.3%) and high specificity (99.1%) in diabetes diagnosis. Sensitivity and specificity of HbA1c to detect abnormal glucose tolerance were 29.5% and 95.2%, respectively. The consistency in classifying abnormal glucose tolerance between HbA1c and OGTT criteria was 59% (κ = 0.227) and the area under the receiver operating characteristic curve was 0.708. The combined use of HbA1c and fasting glucose criteria showed similar performance to that of fasting glucose criteria alone. The latter identified 63% of the women with pre-diabetes or diabetes in the study cohort. However, by lo Continue reading >>

Hba1c And Pregnancy

Hba1c And Pregnancy

Tweet Keeping blood sugar levels under control is hugely important for women who either have diabetes going into pregnancy or who develop diabetes during their pregnancy. Tight blood glucose control helps increase the chances of a successful pregnancy by cutting the risk of complications for your baby. If you have diabetes, one of the ways your doctor or nurse will monitor your glycemic control is by carrying out a HbA1c test. The HbA1c test measures glycated haemoglobin - a molecule within red blood cells that naturally bonds with glucose - to get a good indication of your average blood glucose over the past 8-12 weeks. This guide outlines when your HbA1c readings will be taken and what HbA1c values should be before (planning stage), during and after your pregnancy. Planning pregnancy The NICE guidelines for Diabetes in Pregnancy (Clinical Guideline 63) state that women with diabetes should aim to achieve an HbA1c result of 43 mmol/mol (6.1%) or lower. If you are planning to become pregnant, you should be offered an HbA1c measurement on a monthly basis to help monitor your blood glucose control. Meeting the target will help to minimise the risk of the baby developing risk of congenital malformations. If you have an HbA1c above 10%, it is strongly advised to avoid becoming pregnant until good diabetes control is achieved and sustained. During pregnancy During the first trimester of pregnancy, the HbA1c target for women with diabetes is the same as for planning a pregnancy, that is 43 mmol/mol (6.1%) or lower. During the second and third trimesters of pregnancy, from week 13 onwards, HbA1c should not be used for assessing blood glucose control. Throughout pregnancy, women with diabetes should aim to meet the following blood glucose targets Before meals: 3.5 to 5.9 mmol/l Continue reading >>

Pregnancy With Type 1 Diabetes: A1c Strategies That Work For Me

Pregnancy With Type 1 Diabetes: A1c Strategies That Work For Me

Pregnancy with Type 1 Diabetes: A1C Strategies that Work For Me Im officially 20 weeks pregnant! Yahoo, half-way there (and if youre a diabetic then you know they wont let you go past 38 weeks, so Im technicallymorethan half-way there)! Im so relieved to share that my latest A1C came back at 5.7 percent. While that is exactly what Im aiming for and hoping for, it also feels like a slight miracle during this 2nd pregnancy when most of my day is about chasing after a toddler and trying to work part-time during each free moment I get! Theres little time left for obsessing about blood sugar levels and taking extra tiny little doses of correction insulin, let alone eating! (For example: today, I ate lunch at 4 p.m. because of dentist appointment + picking up toddler at friends house + walking dog + gettingtoddler down for nap + getting on the phone for an hour-long work meeting + toddler woke up from nap way too early = mama is just catching her breath.) Heres an A1C translation chart so you can see what your A1C means in terms of blood sugar levels. During my 1st pregnancy, my A1C goals were as low as possible because I had all the energy in the world to devote to blood sugar management (exercising daily, eating healthy foods, planning all meals ahead so I can pre-bolus exactly the right amount of time for that mealyada yada yada.) It led to A1Cs as low as 5.1 percent the first time around something Ive expressed in previous blogs I am not even interested in achieving as a pregnant gal with a toddler! But I still have goals: like keeping my A1C between 5.7 and 6.1 percent. Here are a few simple things that help meachieve my A1C goals: 1.Somelow-carb meals: Eatingsomemeals that are low-carb so the work involved in maintaining tight, in-range blood sugar levelsafterthat meal Continue reading >>

Why Hemoglobin A1c Is Not A Reliable Marker

Why Hemoglobin A1c Is Not A Reliable Marker

i was recently tested for Hemoglobin A1c because i presented to an endocrinologist with extremely low blood glucose on lab test and some scary symptoms, not the ordinary hypoglycemia symptoms. My A1c was 4.7 which registered as low (L) on the lab print out–it was only slightly low. Does a low score on this suggest a possibility of short-lived RBCs? Does it have any relationship with extremely low blood glucose? my result at the lab, fasting, was 32mg/dL. Not long after that i got a home glucometer and i get the same kind of results on that as the lab got, in the 20s and 30s first thing in the morning, every day. did not know i had hypoglycemia until i had that lab test, though i had had one episode where i woke up with ataxia, i fell while walking to the bathroom first thing in the morning, i got up and immediately fell again. I soon found that i had very impaired coordination. i did not know why and i was very worried. Eventually i wanted to have breakfast but had great difficulty holding the measuring cup under the faucet, to get some water to heat, to make instant oatmeal, i lacked the coordination to get the water into the cup. I persisted and did make the instant oatmeal (pour hot water onto flakes and it’s done), and i got my lap top and was eating the oatmeal and i suddenly was aware that the symptoms were going away. Previously i had been unable to type. While eating the small amount of oatmeal, i realized i could type. That was about a month before the lab test. Since it only happened that once, i put it out of my mind. About 5 days after the lab test, i had the second episode, worse than the first, i woke falling out of bed to the floor, couldn’t use my arm to break the fall, i didn’t have the coordination. i sat on the floor, i could not get up and wa Continue reading >>

Gestational Diabetes

Gestational Diabetes

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Type 2 Diabetes article more useful, or one of our other health articles. This article deals only with gestational diabetes. There is a separate Diabetes in Pregnancy article, which provides information about pregnancy in women with pre-existing diabetes. Gestational diabetes mellitus (GDM) is any degree of glucose intolerance with its onset (or first diagnosis) during pregnancy and usually resolving shortly after delivery[1]. Pregnancy hormones decrease fasting glucose levels, increase fat deposition, delay gastric emptying and increase appetite. However, over the course of pregnancy, postprandial glucose concentrations increase as insulin resistance increases. This is normally countered by an increased production of insulin but in women with GDM there is an insufficient compensatory rise[2]. There is no clear agreement on diagnostic criteria[3]. Pregnancy hyperglycaemia without meeting GDM diagnostic criteria affects a significant proportion of pregnant women each year and is associated with a range of adverse pregnancy outcomes[4]. The National Institute for Health and Care Excellence (NICE) recommends that GDM should be diagnosed if the pregnant woman has either[5]: Fasting plasma glucose level of 5.6 mmol/L or above; or Two-hour plasma glucose level of 7.8 mmol/L or above. Although the World Health Organization (WHO) now recommends that HbA1c can be used as a diagnostic test for diabetes, it is currently not recommended for diagnosis during pregnancy[6]. Many of the problems associated with GDM are common to established diabetes in pregnancy - hype Continue reading >>

Glycosylated Haemoglobin For Screening And Diagnosis Of Gestational Diabetes Mellitus

Glycosylated Haemoglobin For Screening And Diagnosis Of Gestational Diabetes Mellitus

Abstract Objectives The oral glucose tolerance test (OGTT) is a cumbersome test that is time consuming, labour intensive and often poorly tolerated by pregnant women. To date, glycosylated haemoglobin (HbA1c) is the most accepted measure of chronic glycaemia outside of pregnancy. HbA1c is an uncomplicated test, less time consuming, does not require any specific patient preparation and is considered straightforward compared with the OGTT. Therefore, we prospectively tested the utility of the HbA1c when used as a screening tool in pregnancy for gestational diabetes mellitus (GDM). Settings Primary health care. Single tertiary referral centre, Tasmania, Australia. Participants A direct comparison between HbA1c levels and the OGTT results in pregnant women, tested concurrently at the 24–28 gestational week, was undertaken. A full profile of 480 pregnant women during the period from September 2012 to July 2014 was completed. Median and mean age of participants was 29 years (range 18–47 years). Interventions A simultaneous prospective assessment of HbA1c versus standard OGTT in a cohort of consecutive pregnant women presenting to our institute was performed. Results The number of women who had GDM according to OGTT criteria was 57, representing 11.9% of the evaluated 480 pregnant women. Using a cut-off value for HbA1c at 5.1% (32 mmol/mol) for detecting GDM showed sensitivity of 61% and specificity of 68% with negative predictive value (NPV) of 93%, versus sensitivity of 27% and specificity of 95% with NPV of 91% when using HbA1c cut-off value of 5.4% (36 mmol/mol). Conclusions Our results suggest that pregnant women with an HbA1c of≥5.4% (36 mmol/mol) should proceed with an OGTT. This may result in a significant reduction in the burden of testing on both patients and t Continue reading >>

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