Gestational diabetes is a type of diabetes that develops during pregnancy when the body cannot produce enough insulin to regulate blood sugar levels. It is caused by hormonal changes during pregnancy that make cells more resistant to insulin, combined with insufficient insulin production by the pancreas. The Hemoglobin A1c test is the most important blood test for monitoring gestational diabetes because it reveals average blood glucose levels over the past 2-3 months.
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Gestational diabetes is caused by hormonal changes during pregnancy that affect how your body processes insulin. During pregnancy, the placenta produces hormones like human placental lactogen, estrogen, and cortisol that help the baby develop but also block insulin action in the mother's body, creating insulin resistance. When the pancreas cannot produce enough extra insulin to overcome this resistance, blood sugar levels rise and gestational diabetes develops, typically in the second or third trimester when these hormonal changes peak.
The Hemoglobin A1c test is the most important blood test for monitoring gestational diabetes because it measures your average blood glucose levels over the past 2-3 months by detecting glucose attached to hemoglobin in red blood cells. This test provides a comprehensive picture of blood sugar control throughout pregnancy, unlike single-point glucose tests that only capture your levels at one moment in time. While the oral glucose tolerance test remains the standard for initial diagnosis, the Hemoglobin A1c test is essential for ongoing management and helps your healthcare provider assess whether your treatment plan is effectively controlling your blood sugar to prevent complications for both you and your baby.
You should get tested if you are between 24 and 28 weeks pregnant, as this is when gestational diabetes typically develops and screening is routinely recommended. Earlier testing may be needed if you have risk factors such as being overweight, having a family history of diabetes, previously delivering a baby weighing over 9 pounds, or having had gestational diabetes in a previous pregnancy. You should also get tested if you experience symptoms like excessive thirst, frequent urination, unusual fatigue, or blurred vision during pregnancy, even if you are not yet at 24 weeks.
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What this means
Your HbA1c level of 5.9% falls in the prediabetes range, which means your blood sugar has been slightly elevated over the past 2-3 months. This is an important warning sign, but the good news is that prediabetes can often be reversed with lifestyle changes. Taking action now can help you avoid developing type 2 diabetes and reduce your risk of heart disease and other complications.
Recommended actions
Focus on eating more vegetables, whole grains, and lean proteins while reducing refined carbs and sugary foods
Aim for 150 minutes of moderate exercise per week, like brisk walking or cycling
If overweight, work toward losing 5-10% of your body weight through diet and exercise
Retest in 3-6 months to monitor your progress and see if lifestyle changes are working
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