Aready pregnant 11 weeks with elevated A1c

When I found out I was pregnant a month and a half ago I had an a1c of 8.6 now a month and a half later I have only come down to an 8. It was suggested to me at my first maternal fetal appointment to terminate the pregnancy and try again after I get my sugars better controlled and my kidney issue resolved. The day I found out I was pregnant I was in the pre op unit of the hospital about to have a procedure that may or may not work as per the urologist done to correct the kidney reflux issue that had gone undetected by doctors for 30 plus years and has left my left kidney significantly damaged. I have been told of all the risks involed with having a child with an elevated a1c but feel that this is my window of opportunity. I am 35 years old and do not want to wait any longer. I am really scared of what is to come for both my baby and myself. I am just hoping to hear from other women who may have similar stories and had positive outcomes

You are between a rock and a hard place, As sad as it would be, I would advise my daughter to take the medical advice given, They seem to think it’s not a good idea for your health at this stage and the pregnancy may already be not viable.

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It’s not really fair for me to reply because I’m not type 1 - I’m just a mom of a type 1. But I too was told to terminate a baby with a severe heart defect but I chose to have her instead. I will never ever regret having her and no matter what the dr’s tell you, it’s just not a simple process to ‘terminate’ a pregnancy and then get your bg under control and get pregnant again. No ones knows what the future holds and what if you are never ever able to have another baby?

My advice would be to read and research and figure out how you can get your bg in check. I did a quick check on the internet and lots of women have done moderately low carb diets during pregnancy and have done well… or find something else that works for you. But you have this gift of a baby right now and my advice would be to work your butt off to keep it . :slight_smile:

I [sadly] must agree with jack16. As a woman who miscarried twice and has two wonderful daughters (my last child was born when I was 44 years old), I can understand your reluctance to terminate this pregnancy. But it appears that the odds are stacked against you at the current time (with your high A1c, but most importantly your serious health condition) and I don’t believe it is worth the risk to your life.


I confess to knowing almost nothing concerning
kidney conditions. Once in my life (I am 67) I had a
bad kidney infection when I was about 20, treated with antibiotics. Blood work up to present show no kidney problems.

Irrespective of your self-reported kidney damage, I’d just like to put my 2 cents in concerning a D pregnancy.

I’ve had 2 viable pregnancies ( none non-viable).
And I want you to know that I was 16 when I was dx’d with Tyoe 1 and that was before A1-C’s came into play.

I had a wonderful high-risk Doctor in NYC. I was never put on a D diet.

Sorry, I don’t mean to bore you. All I want to say is that D women before A-1C’s snd before glucose testing, delivered healthy babies. My sons turn 40 and 37 this year.

As to your direction, I’d pay attention to test results and follow your gut and your heart.

Wishing you the very best,
Joedy :two_hearts:


This sounds like a really tough place to be in and a really hard decision to make. What are you doing currently to control your blood sugar? Are you already using insulin or eating any kind of low-carb diet? The risks of a high A1C are real (and I believe it’s recommended that your A1C be below 6.5 for pregnancy), especially since the fetus is developing internal organs precisely at this point in the pregnancy.

Good luck to you! I wonder, also, if you could find a second opinion or recommendation from another MFM, to see if there’s anything you can do quickly to get things under control.


I will not reply on the termination of pregnancy. There are real risks with high a1c, but whether those risks will or will not be realized remains to be seen. I understand exactly how you feel about the clock ticking and wanting this baby so much.

What you can do here and now is to work very aggressively to lower blood sugar.

Do you have a CGM? I hope you do. It will be an invaluable tool.

You need to dose insulin quite aggressively, correct highs aggressively, and monitor very closely to prevent lows and catch highs. This includes monitoring during the night.

I have had 2 diabetic pregnancies on insulin and found that eating very low carb was the best and most effective way to help the insulin work. As I was told, your baby doesn’t know if you eat carbs or not, it is the blood sugar levels that affect the baby. So do everything you can to bring sugars down and keep them down. Even with very low carb I had to take a lot of insulin.

Prayers for you.

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First off, I’m so sorry you’re facing this dilemma. It truly is a heartbreaking one to have to face.

The main thing I would say is that no one except you can decide which risks are worth taking.

I will say that I looked at one study, and it seems like the rates of miscarriage and birth defects is certainly correlated with blood sugar control – but that the majority of women will not face the most serious issues.

The paper I saw is here:
Obviously, you want to give your child the best start in life you can, which means doing your best to control your blood sugar, but even if your A1C is very high (>10.4%), the risk of serious birth defects was 16.4% – that is, if 100 women had an average A1C of 10.4%, 86 of their kids would NOT have serious birth defects. The baseline rate in the general population is about 3%.

The second issue is one I’m not able to speak to at all, as I don’t know what your kidney issues are, how they elevate your risk, and what your risk would be if you choose to carry to term. That, to me seems ultimately a question of your tolerance for personal risk.

Having kids is, honestly, one of the riskiest things that the average, non-thrill seeking person will do in their lifetimes. IT’s just scary no matter what!

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They didn’t even consider an a1c of 8.6 to be elevated until very recent history in the grand scheme of things. Many thousands of healthy children have been born to women with a1c in the mid 8s… I don’t k ow enough about kidneys to understand the risks inherent in that aspect of your issue

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