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Hba1c 6.3 Pregnant

Ten Things You Need To Know Before You Get Pregnant If You Have Diabetes

Ten Things You Need To Know Before You Get Pregnant If You Have Diabetes

10/07/2015 16:57 BST | Updated 10/07/2016 10:59 BST Ten Things You Need to Know Before You Get Pregnant if You Have Diabetes Suzi Godson The Times sex columnist and editor of www.suzigodson.com 1. Pregnancy can be a challenge for any woman, but for women suffering from diabetes, it presents a very particular set of problems. There are two different forms of diabetes; Type 1, which is relatively rare, and Type 2 which accounts for 90% of all diabetes. Both forms of diabetes interfere with the bodies ability to regulate blood sugar levels and this can cause serious complications for women who want to have children. 2. High blood sugars quadruple the risk of birth defects, so it is essential for women with diabetes to have good blood sugar control for at least three months before they get pregnant. Despite the need for careful pre-pregnancy diabetes planning, the Confidential Enquiry into Maternal and Child Health Diabetes Programme (CEMACH) which was set up to provide an overview of diabetes maternity services, national pregnancy outcome rates and standards of care, found that between 2002 and 2003, fewer than half (41%) of women with diabetes studied in the enquiry had planned their pregnancy. This compared to a planned pregnancy rate of 58% in the general maternity population in 2001-02. 3. Evidence for the positive impact of good glucose control on perinatal outcome has been available since the 1980s, but the CEMACH enquiry also found that the majority of diabetic women entered pregnancy with poor blood sugar control. 4. Women suffering from diabetes are advised to have regular HbA1c testing prior to getting pregnant in order to reduce the risk of adverse outcomes. HbA1c testing measures the amount of glucose-bound haemoglobin and reflects how well blood sugar levels 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 >>

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 >>

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 >>

Hemoglobin A1c Test (hba1c, A1c, Hb1c)

Hemoglobin A1c Test (hba1c, A1c, Hb1c)

Hemoglobin A1c definition and facts Hemoglobin A1c is a protein on the surface of red blood cells that sugar molecules stick to, usually for the life of the red blood cell (about three months). The higher the level of glucose in the blood, the higher the level of hemoglobin A1c is detectable on red blood cells. Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time period. Normal ranges for hemoglobin A1c in people without diabetes is about 4% to 5.9%. People with diabetes with poor glucose control have hemoglobin A1c levels above 7%. Hemoglobin A1c levels are routinely used to determine blood sugar control over time in people with diabetes. Decreasing hemoglobin A1c levels by 1% may decrease the risk of microvascular complications (for example, diabetic eye, nerve, or kidney disease) by 10%. Hemoglobin A1c levels should be checked, according to the American Diabetic Association, every six months in individuals with stable blood sugar control, and every three months if the person is trying to establish stable blood sugar control. Hemoglobin A1c has many other names such as glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin, and HbA1c. To explain what hemoglobin A1c is, think in simple terms. Sugar sticks to things, and when it has been stuck to something for a long time it's harder to the get sugar (glucose) off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar (glucose) sticks to these red blood cells by binding to hemoglobin A1c, it gives us an idea of how much glucose has been around in the blood for the preceding three months. Hemoglobin A1c is a minor component of hemoglobin to which gl Continue reading >>

Application Of Glycated Hemoglobin In The Perinatal Period

Application Of Glycated Hemoglobin In The Perinatal Period

Go to: Introduction Glycated hemoglobin (HbA1c) has been widely accepted as an indicator used to evaluate the blood glucose control in diabetes mellitus (DM) patients. However, evidence on the application of HbA1c in the diagnosis and follow up of gestational diabetes mellitus (GDM) and pregnancy combined DM is very poor. Herein, we summarize the available studies on this issue. Concept of HbA1c HbA1c is a special fragment formed by the binding of glucose to the C chain or D chain of hemoglobin A (HbA) and as a result of non-enzymatic catalysis of mature hemoglobin (Hb) and glucose. The synthesis of HbA1c is very slow and relatively irreversible. HbA1c can maintain in the whole lifespan (120 days) of red blood cells. The synthesis rate of HbA1c is positively rated to the glucose concentration of red blood cells and HbA1c can reflect the mean blood glucose level within past 8 to 10 weeks. The HbA1c is independent of accurate glucose detection, the acute change in blood glucose and the interval between prior meal and HbA1c detection. In addition, HbA1c detection has good repeatability, and is stable and not influenced by the time of blood collection, fasting status and use of insulin. In addition to self-measurement of capillary blood glucose, HbA1c detection is an established tool in the assessment of glycemic control [1]. In the 59th Annual Meeting of Diabetes Association of USA, HbA1c detection is recommended as a golden standard for evaluating the glucose control. HbA1c and normal pregnancy In non-pregnant women, the HbA1c is 4.7-6.3% [2]. However, in pregnant women, the HbA1c might be lower than that in healthy controls because 1) pregnant women are younger and the fasting blood glucose increases over age. Thus, relatively older, healthy non-pregnant women may have h Continue reading >>

Glycosylated Hemoglobin Values In Nondiabetic Pregnant Women In The Third Trimester And Adverse Fetal Outcomes: An Observational Study Shobha P, Mathen S, Abraham J - J Family Med Prim Care

Glycosylated Hemoglobin Values In Nondiabetic Pregnant Women In The Third Trimester And Adverse Fetal Outcomes: An Observational Study Shobha P, Mathen S, Abraham J - J Family Med Prim Care

Objective: The objective of the study is to estimate the level of glycosylated hemoglobin (HbA1c) for a safe fetal outcome and to estimate the relation between this level and various adverse fetal outcomes. Materials and Methodology: Primigravidas who are diagnosed as not having gestational diabetes mellitus as per the glucose challenge test done at 24 weeks with a cutoff value up to 140 mg/dl are followed up at 30-34 weeks for the estimation of HbA1c in the blood and further till the time of delivery and postnatal period for the fetal outcomes. Data were collected based on detailed patient interview, clinical examination, and laboratory investigations. Data were analyzed to obtain the mean value of HbA1c in the third trimester. Fetal outcomes were analyzed with the HbA1c value using Chi-square test. Results: The HbA1c values in the third trimester of pregnancy in this study ranged from 4.5% to 6%. Discussion: Unfavorable outcomes were found the least in the 4.5%-5%. The average plasma blood glucose corresponding to HbA1c value of 5% is 101 mg/dl. The majority of the newborn were admitted for observation for transient tachypnea (49.5%) and hyperbilirubinemia (16.5%) requiring phototherapy, hypocalcemia requiring calcium supplements (12.6%), hypoglycemia requiring glucose (7.8%), and persistent tachypnea of newborn (5.8%) and all the outcomes correlated significantly with HbA1c values. Conclusion: Hence, HbA1c can be utilized for the monitoring of glycemic level and as screening test. Keywords:Fetal outcomes, glycosylated hemoglobin, nonpregnant diabetic women, third trimester Shobha P, Mathen S, Abraham J. Glycosylated hemoglobin values in nondiabetic pregnant women in the third trimester and adverse fetal outcomes: An observational study. J Family Med Prim Care 2016;5 Continue reading >>

Pregnancy And Diabetes ~ One Womans Story

Pregnancy And Diabetes ~ One Womans Story

Home / Blog / Pregnancy and Diabetes ~ One womans story Pregnancy and Diabetes ~ One womans story Deciding to get pregnant was something I started discussing with my endocrinologist about a year before I married my husband. He informed me that the closer my A1C was to 6% prior to pregnancy, the less risk there would be of birth defects and complications. I have never had that hard of a time keeping my diabetes under control. I generally check my sugars 2-3 times a day and wear an insulin pump and have been able to keep my A1C between 6.5% 7% for yearsthat was always good enough for me. But it definitely wasnt going to be enough for my unborn child. So, I started to test 3-4 times a day and was more careful with my carb counting. I had also occasionally taken pump breaks and used needles for a few days at a time. I stopped that completely and made sure that my pump was in at all times. So for the two years prior to conceiving, I kept my A1C under 6.5%. A few months before we started trying, I met with a diabetic nutritionist, a maternal fetal medicine doctor, my OB and of course my endocrinologist. The endocrinologist was satisfied with my A1C of 6.3%, but my OB wanted it under 5.5%! I have never had an A1C under 6% and for me, I wasnt sure I could achieve that without a lot of hypos. So I stuck with the endocrinologists recommendations. It took about 4 months to conceive and during that time we moved from South Jersey to North Jersey. I met with my new endocrinologist less than a month before getting pregnant. Thankfully my OB was already in North Jersey, so I didnt have to establish a new relationship with the doctor who would deliver my baby. At the endos appointment in July, my A1C was 6.0%, which was the lowest it had been in a long time, so I was thrilled about th Continue reading >>

Diabetes In Pregnancy - Clinical Review

Diabetes In Pregnancy - Clinical Review

Section 1: Epidemiology and aetiology The diagnosis of diabetes in pregnancy is arbitrary, depending on where the cut-off is placed on the normal spectrum of glucose tolerance. About 2-5% of UK pregnancies are affected by diabetes.1 This may be pre-existing type 1 or 2, or onset during pregnancy (gestational). All adverse outcomes of pregnancy are increased by diabetes (see box 1); this relates to glycaemic control. The most important aim is to achieve maternal normoglycaemia.2-6 In pregnancy, fasting levels of glucose decrease and normal serum levels following a meal increase. Glucose tolerance decreases progressively in each trimester, mostly because of anti-insulin hormones secreted by the placenta - human placental lactogen, glucagon and cortisol. This underlies the increased insulin requirements of women with pre-existing diabetes and the development of abnormal glucose tolerance in gestational diabetes (GDM), where there is insufficient insulin secretion to compensate for the insulin resistance.2 Pre-existing diabetes may be insulin dependent or non-insulin dependent. GDM may be true or previously undiagnosed underlying type 2 diabetes. Type 1 diabetes has a 0.5% prevalence in the UK and tends to present in young, lean children or young adults. Type 2 diabetes has a 3-4% prevalence in the UK, especially affecting older, overweight patients. It is becoming more common as the prevalence of obesity and advanced age in pregnancy increases.3 In the UK, the prevalence of GDM is increased 11 times in women from India, eight times in those from south-east Asia, six times in Mediterranean and Arab women, and three times in African-Caribbean patients.3 Section 2: Making the diagnosis The key feature of management is preconception counselling.1,6 This aims to achieve good gl 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 >>

Hba1c Levels Are Significantly Lower In Early And Late Pregnancy

Hba1c Levels Are Significantly Lower In Early And Late Pregnancy

sparsely investigated with different meth- (5,6,11,12), and reference ranges are gen- All subjects had a random capillary blood based on risk factors for gestational dia- Department of Endocrinology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Department of Obstetrics, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Steno Diabetes Center, Copenhagen, Denmark; and the Odense University Hospital, Odense, Denmark. Address correspondence and reprint requests to Elisabeth Mathiesen, Department of Endocrinology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. E- Received for publication 19 January 2004 and accepted in revised form 20 January 2004. C.G. holds stocks in and receives grant support from Novo Nordisk. Abbreviations: DCCT, Diabetes Control and Complications Trial; OGTT, oral glucose tolerance test. 2004 by the American Diabetes Association. 1200 DIABETES CARE, VOLUME 27, NUMBER 5, MAY 2004 OKane et al. (6), who studied 493 healthy Hartland et al. (5), who investigated 267 in these two studies. Our study included a tolerance test. This might explain why we 10, and is sustained during the remaining level was not measured in this study, and the third trimester of pregnancy, indicat- wide study in the Netherlands. Diabetolo- pre-eclampsia in type I diabetes. Diabeto- type 1 diabetes mellitus: a major potential factor underlying macrosomia (Editorial). 5. Hartland AJ, Smith JM, Clark PMS, Web- trol and complications trial-aligned HbA1c 7. Kilpatrick ES: Glycated haemoglobin in 8. Marshall SM, Barth JH: Standardization of 9. American Diabetes Association: Precon- 10. Worth R, Potter JM, Drury J, Fraser RB, globins. Br J Obstet Gynaecol 86:210213, Glycaemic control is associated with pre- te Continue reading >>

7.7 And Doctors Gave The Go-ahead Ttc

7.7 And Doctors Gave The Go-ahead Ttc

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. I have been wanting to have a 2nd child for about 3 years. Last week I went to see my endo and he said my HBA1C was down from 8.1 to 7.7 in the matter of a month and that he would refer me to perineonatologist. After visiting the peri they said to go ahead and TTC, which puzzled me! My first pregnancy my HBA1C was in the 6.3 range at the beginning and I'm wondering why both doctors would give me the go ahead with a HBA1C in the 7's range. My only guess is that the doctors are under the assumption that I will continue to lower my HBA1C?? I have been waiting 3 years for the go ahead but now that I have it I'm a little scared to proceed. As of right now I am going to wait at least one more month. Has anyone had a healthy pregnancy with a HBA1C in the 7's range??? Both of my pregnancies were "whoops..." ones, but fortunately both times I had A1c's below 7 the first appointment into the endo where I hung my head and went "yeah, so remember how we were talking about birth control...yeah, I didn't make it that far..." (both times it had been a while since I had been in an endocrinologist's office so I was going in once a month). The risks are much greater when you are consistently running BGs that high. That being said however, a 0.4 drop in only a month is a rather impressive step in the right direction. You are doing something right, so keep it up! Just remember that just because your endo gives you the green light doesn't mean that you have to start doing the mattress mambo every night. If you don't feel comfortable conceiving yet, by all means don't. Personally, if I were you, I would keep up wi 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 >>

Diabetes 'increases Birth Defect Risk'

Diabetes 'increases Birth Defect Risk'

“Diabetic mothers-to-be have high risk of giving birth to children with congenital abnormality,” The Guardian said today. The news is based on UK research that compared the rates of birth defects in women with and without diabetes. It found that about 7% of pregnancies in women with diabetes were affected by birth defects that were not caused by problems with the number or structure of the chromosomes. This was 3.8 times higher than the rate in women without diabetes. The study also found that women who have worse control over their blood sugar around the time of conception were at greater risk. It has been known for some time that diabetes in pregnancy is associated with a higher risk of various complications, and this large study provides further evidence on the link between diabetes and birth defects. UK medical guidance already addresses this risk, and recommends that from adolescence onwards, women with diabetes should be routinely given information on the importance of planning any future pregnancies and on getting specialist care and advice when they decide to have a baby. Women with very poor control of their diabetes are also advised not to become pregnant until their blood sugar control has improved. Women with diabetes are likely to already be aware of these risks. However, this study provides another reminder that diabetic women who are thinking about becoming pregnant should discuss their options with their doctor first. Where did the story come from? The study was carried out by researchers from Newcastle University, the Regional Maternity Survey Office in Newcastle, and the South Tees NHS Trust. It was funded by Diabetes UK, the Department of Health, the Healthcare Quality Improvement Partnership, and the four primary care trusts in northeast England. Continue reading >>

31 Weeks, Worried!! Last Hba1c 6.4 And Slightly Larger Baby

31 Weeks, Worried!! Last Hba1c 6.4 And Slightly Larger Baby

Diabetes Forum The Global Diabetes Community This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More. Get the Diabetes Forum App for your phone - available on iOS and Android . Find support, ask questions and share your experiences. Join the community 31 weeks, WORRIED!! last Hba1C 6.4 and slightly larger baby i have been T1 Diabetic for 8 years i am 20 years old and i am extremely worried about my pregnancy. i am currently 31 weeks pregnant and my last Hba1c was 6.4% it has been better than this throughout the pregnancy but lately it has risen, the diabetic doc has been telling me ive been doing really well until today they told me that i need to be more strict, which worried me!! so i had a growth scan and they told me that my baby is slightly larger than normal measuring at the size of a 34 week old baby rather than 31. i am really worried and cant stop thinking about what else i can do to make it better, has anyone else experienced this and what was the outcome of it? will i be induced? will my baby have something wrong with him? please can someone help and put my mind at ease!! Re: 31 weeks, WORRIED!! last Hba1C 6.4 and slightly larger b DON'T worry i have had 3 kids and cos of the diabetes they can tend to be a bit bigger my first was born at 35 weeks and weighed 6lb 1.5oz cos problems with the placenta my 2nd and 3rd were born at 37 weeks 2nd weighing 7lb 6oz and 3rd weighing 6lb 14oz they were all healthy. Due to the sugar in your blood the baby will take it which causes the weight gain but to me a HBC1a of 6.4 is good. Doctors can sometimes go OTT with everything , When i was pregnant with my first my G.P at the time told me i had to keep my sugar levels at 3.3 which is HYPO and me being so nieve at the time t Continue reading >>

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