Kids at Risk For Diabetes

Registered Nurse, Diabetes Educator, CDE, Obesity, Children, Youth, Lifestyle

Julie RN DCES

8 Tips to Avoid Gestational Diabetes

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Gestational diabetes can be frightening. Women typically get tested between 24-28 weeks gestation. But you can avoid gestational diabetes by knowing your risks and taking action steps to avoid these problems.

Evaluate Your Risk

According to the American College of Obstetrics and Gynecology and the American Diabetes Association your risks include:

  1. Over the age of 25
  2. A body mass index (BMI) over 25
  3. A family history of diabetes in a parent, sibling, or a child
  4. A history of a baby born over 9 pounds
  5. Ethic groups at highest risk include Pacific Islanders, Asians, Hispanic
    and certain Native American tribes.
  6. A random blood sugar test over 200
  7. A1C test equal to or greater than 5.7%
  8. A history of Polycystic Ovary Disease
  9. High triglycerides or a prescription to control triglycerides.

It is Proven that Gestational Diabetes can be Prevented

The American Diabetes Association has proven through the Diabetes Prevention Program (DPP) that lifestyle changes can prevent or delay the diagnosis of diabetes. It is believed that gestational diabetes can be prevented through lifestyle changes. Gestational diabetes is controlled by pregnancy hormones, so you need to make changes early in your pregnancy. As your pregnancy develops, it will become increasingly difficult to control your blood sugar because of your changing hormones. Learning how eat for your body’s needs is essential.

8 Tips to Avoid Gestational Diabetes:

  1. Eat 3 equally spaced meals each day
  2. Limit snacks between meals. (once you start following the gestational meal plan you will have nutritionally balanced snacks between meals and one at bedtime.
  3. Eat a balanced diet (limit sugar, fat, and salt)
  4. Include fresh fruits and vegetables as much as possible
  5. Include whole grains
  6. Limit saturated fats
  7. Avoid sugary drinks and rich desserts
  8. Learn to check labels for portion sizes (Do not eat for two – you need to control your weight gain during pregnancy!)

Making lifestyle changes is very difficult. It is said that it takes 3 months to change a habit. My eBook (coming soon!) will talk about ways to help make changes that will last.

Together we can make a difference in your future.

Please keep an eye out for my eBook – coming soon!

 

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The Link between Pregnancy and Diabetes    

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Did you know there’s a connection between Pregnancy and Diabetes? And did you know there’s also a connection between Gestational Diabetes and Type 2 Diabetes?

Read on to understand the connections.

Scenario:

Woman in her late twenties gets pregnant. At 26 weeks, she takes an oral glucose tolerance test (OGTT) and is diagnosed with gestational diabetes. She is challenged to keep her blood sugar within the recommended zone.

At 32 weeks gestation, she starts having trouble with high blood pressure (hypertension). Her doctor admits her into the hospital on mandatory bed rest. They give her drugs to encourage fetal lung development. She is informed she will be induced.

During the induction, it is determined the baby is not in the head down position. She is immediately scheduled for a C-section.

After delivery, the new mother’s blood sugar is higher than normal. Her baby has a poor sucking reflex which makes it difficult to nurse. For some unknown reason, the nurses want the new mother to nurse at least every hour. The medical staff informs her that stress can cause elevated blood sugars and she is not to worry.

Follow-up appointment:

Her doctor recommends she returns for a follow-up appointment at 3 weeks. She feels that is a little odd, but they explain it is the new recommendation and will be covered by her insurance.

At 3 weeks, she is feeling better and the baby is doing better nursing. They take a random blood sugar test and it is a little high. She explained that since she was out of the house, she treated herself to a deep dish pizza. She believes that her lunch was the reason her blood sugars were a little high because every time she ate pizza while she was pregnant, her blood sugars would go up for a long time. Her nurse smiled and said, “We’ll keep an eye on it.”

At her next follow-up appointment, her doctor required an A1c test. Her result was 6.8. She was diagnosed with type 2 diabetes. She now blames her pregnancy on her diagnosis and she is convinced it will go away.

What went wrong?

Chances are she was prediabetic (aka borderline diabetic) before the pregnancy. Her fasting blood sugar tests were normal, because through the night her body could bring her blood sugar into normal range.

The A1c test is an average blood sugar test over the previous 2-3 months. Unfortunately, once you are diagnosed, you will always be flagged as at-risk for high blood sugar.

Pregnancy places a stress on your body in many ways. There are a lot of hormone shifts during pregnancy. Diabetes is caused by the hormones required to grow the placenta. The larger the placenta gets, the more you become at risk for high blood sugar.

This is the reason the oral glucose tolerance test is delayed until 26-28 weeks gestation. After delivery and you expel the placenta, your body should go back to normal.

One complication from uncontrolled blood sugar is eclampsia. This is a chemical reaction that causes uncontrolled high blood pressure. It causes heart problems and sometimes death of the baby and/or the mother.

When blood pressure (BP) starts to increase, doctors are proactive and require strict bed rest to prevent the chemical progression of pre-eclampsia into eclampsia. The doctor will induce as soon as it is safe. Many times, the baby is not in the correct position, so the doctor will do a C-section.

Typically, your blood sugar will go back to normal after delivery. But we all gain weight with pregnancy. It is very possible someone can develop insulin resistance from the weight gain. Hopefully this is a temporary condition. Sometimes it can take over a year to lose the weight. If you have developed insulin resistance, you can have prolonged sugar problems.

Once diagnosed, always a diabetic

The standard for diagnosing type two diabetes has changed. Previously, you needed two fasting blood sugar results over 125. Today, you only need one.

The medical community is trying to diagnose earlier in this disease progression to encourage lifestyle changes. Women who develop Gestational Diabetes are at high risk for developing Type 2.

Over 40% will be diagnosed within 5 years. When this disease is diagnosed early, there is a better chance of reversing it. Your diagnosis may be changed to T2 in remission, but you will always be at risk of it returning as you age.

Knowledge is Power

The internet has a lot of suggestions to reverse diabetes. Unfortunately, many of the suggestions you’ll find online are false or misleading. The American Diabetes Association encourages a balanced lifestyle. Remember, only 1% of people who attempt irrational weight control are successful in the long run. Yo-yo dieting is very hard on your body and can cause other health problems.

Slow and steady wins the race!

Many people need support to make and maintain new habits. If you need help setting realistic goals and sticking to what you really want to do, I can help you.

 

About the author

Julie Stelting is a registered nurse with a bachelor’s degree in nutrition. She is the founder of Kids at Risk for Diabetes LLC. Julie designed a program for gestational diabetes, to help women understand and cope with their diagnosis. She is passionate about preventing or delaying diabetes through holistic lifestyle changes.

For more information go to www.kidsatriskfordiabetes.com, or email Julie directly at Julie@kidsatriskfordiabetes.com.

 

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Help for Diabetes During Pregnancy

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Your Gestational Diabetes Diagnosis can be Traumatic

When you are pregnant, being diagnosed with gestational diabetes is the last thing you want to hear. You are given a crash course on how to manage your blood sugar with diet and exercise. You are so stressed out, you probably don’t remember one tenth of what was said.  Your stress continues as you try to “manage” your blood sugar by testing multiple times each day. You feel like your body has betrayed you. All you want to do is have a healthy baby. I know what you’re going through.

Fasting Blood Sugar Test

The American College of Obstetrics and Gynecology (ACOG) is now requiring new clients to have a fasting blood sugar test during early pregnancy to determine un-diagnosed Type 2 and prediabetes in their patients.  Due to the average woman waiting to have their first child later in life and the increasing weight problems they face with age, pregnant women are at increased risk for developing sugar problems. (Get my free gift to evaluate your risk for gestational diabetes.)

How Does Gestational Diabetes Affect You and Your Baby?

At about 12 weeks gestation, your baby starts growing rapidly. This requires increasing amounts of energy, and insulin requirements increase accordingly. Around week 24, your body’s insulin production cannot keep up with your baby’s growth.

Typically, the fasting blood test for gestational diabetes happens between weeks 24-28. The ACOG is allowing your blood sugars to increase enough during the day so that your body can not recover through the night. At that time a random blood sugar test over 200 is a positive result for gestational diabetes.

Your baby continues to grow until about 36 weeks gestation. At delivery, the hormonal effects of the pregnancy disappear and the demand for insulin drops dramatically. Postpartum, your body’s requirement for insulin can go below normal. Many women are placed on IV insulin during labor and they need to be monitored carefully during postpartum.

After Gestational Diabetes Delivery

Because your baby has developed in a blood supply rich in sugar, your baby’s pancreas will also go through an adjustment after delivery. You will see the nursing staff taking blood samples from your baby. Don’t get excited. They will monitor your baby’s blood sugar as needed to keep them safe.

Since insulin requirements shift dramatically during pregnancy, true diabetics need to be monitored carefully for adjustments in their medications. Type 1 diabetics need to be under the care of an endocrinologist throughout their pregnancy. Type 2 diabetes should expect to be placed on insulin during pregnancy. They should also expect to have weekly insulin adjustments.

What to do Before You Get Pregnant

To have a successful pregnancy without complications, all diabetics need to have their blood sugars under good control for six months before conception. The success of their ability to control their blood sugar is often determined by an A1C test.

If you need support in controlling your blood sugars before pregnancy, consider my 1:1 phone consultation program. For a free evaluation please schedule a FREE call with me.

Wishing you a happy pregnancy and a healthy baby!

Julie

P.S. Remember to get my list to evaluate your risk for gestational diabetes.

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What You Need with Gestational Diabetes

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What’s Missing from your Gestational Diabetes Program?

Women diagnosed with gestational diabetes (GDM) get lots of information on how to care for themselves, but many of you will still end up with preeclampsia or C-sections?

Do you feel you need more support from your diabetes team?

Could it be improved?

Read on to see My Solution…

The Current Program

Gestational diabetes programs vary greatly. Many areas do not offer support for the confusing disease.

Do you know what to do when your blood sugar is too high?

Do you have someone to contact for emotional support?

Do you know what it means when your blood pressure starts running too high?

Are you afraid of ending up on insulin?

What’s missing?

There are lots of educational resources available. Unfortunately, many of the programs are provided when it is convenient to the provider, for example, classes you need to attend at the hospital. And many programs are missing the emotional support so many women need.

When are Gestational Diabetes women ready to learn?

Whenever someone is diagnosed with a chronic disease like diabetes, their first reaction is shock.

After the shock of the diagnoses, they will progress through the 5 stages of grieving starting with denial.

  • Denial – trying to avoid the inevitable, “Do the test again”
  • Anger or frustration – the coming out of pinned up emotions
  • Bargaining with their provider or with God
  • Depression – the realization of the inevitable
  • Acceptance and finding a way forward in their life

I have heard so many women, who have been diagnosed with gestational diabetes say, “How can this test be right? I must have eaten too much the day before the test.”

Unfortunately, gestational diabetes is 100% driven by the hormones produced during pregnancy.

It is critical that you understand that your condition will get worse before delivery.

Timing is everything!

When you are in denial, it is difficult to remember details.

When I taught our gestational diabetes classes, my patients were within two weeks of being diagnosed. Many of them were frustrated and feeling betrayed by their body. Their providers wanted them to start testing their blood sugar immediately multiple times a day.

For half of one day, I provided diabetes management techniques through a program at the hospital. Only a few of the women took notes. Many were in shock’s first phase of denial.

They knew diabetes caused “big babies” which placed them at risk for C-sections. But they had tunnel vision; they were focusing on the problems and not the solutions.

The Results

They did not know how to reduce their blood sugar when it was too high. In the end, many of our patients ended up with pre-eclampsia, in the hospital on bed rest, with induced labor when their baby’s lungs were developed enough to sustain life. The result was pre-term babies being delivered to save the mother’s life.

The Solution: Emotional support

These women needed a support system. A place where you can ask questions and get workable solutions from people who have had the same experiences. An on-line support system can be a great resource for finding solutions that work. But you must carefully check the source of your information.  On the web, everyone has an opinion.

Also, due to the pregnancy brain fog, women need on-going training. Many times, they are given information that they don’t need to put into practice right away. They forget important information. They need a place to store a resource of information.

Women need encouragement. In the beginning, their blood sugars are not too bad. They don’t want to test their blood five times a day because it makes their fingers hurt. Many of them stop checking because they are in denial. Unfortunately, as the pregnancy progresses, the blood sugars will get worse.

Many clients complain that they don’t know what to do if their numbers are high. They feel helpless! They need someone to answer questions.

My Solution

“Healthy Babies from Preconception to Birth and Beyond” is an online virtual program designed specifically to assist gestational diabetes patients and type 2 patients who are pregnant or want to become pregnant.

  • They will receive daily emails. (currently this is 27 emails)
  • They can store the emails in a file where they can refer back to them as needed.
  • The course includes tips and activities they can do at their convenience.
  • They will also join a private Facebook group where they can ask questions of each other, share stories, and offer support to each other. I monitor the content for accuracy and provide answers.

Join my mailing list right here and I’ll send you more details about the Healthy Baby course.

If you are curious, but not sure if this program is right for you or your loved one, schedule a free call with me and we can talk through it together.

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Prevent Birth Defects from uncontrolled blood sugars

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Uncontrolled blood sugars can cause serious birth defects.

It is unfortunate that I find a need to present this information. I have experience working with thousands of teens and unfortunately many of them get pregnant. I am located in the American Bible belt. They encourage schools to teach “abstinence only” in sex education classes. In today’s society, it appears to not be effective in controlling unwanted pregnancies.

Never trust your schools to adequately prepare your children for pregnancy prevention.

All parents need to take an active role in the discussion of sex and the importance of contraception. Do not expect your child to be adequately informed by the school’s sex education classes.

Know your risks. Research shows, if the mother has gestational diabetes, the child is at increased risk for diabetes. There are a variety of risk factors that can be found on the CDC’s website on Diabetes. You can take their survey to evaluate your child’s risks.

Type 2 diabetics are at risk for the most serious complications in unplanned pregnancies. About 7% of embryos developed with high blood sugars also develop Spinal Bifida. There are other brain and heart malformations that are associated with uncontrolled diabetes.

Typically, babies born under gestational diabetes are over nine pounds. Doctors recommend C-sections due to the increased possibility of broken bones during birth (particularly the collar bone).

The most serious health issue is high blood pressure in the mothers. This can be life threatening to the pregnant woman. If the mother develops high blood pressure, she will often times be placed in the hospital on bed rest until the baby is developed enough to be induced. There is a risk of underdeveloped lungs in the newborn and high medical cost for intensive care for the newborn.

There is a wide variety of birth defects associate with high blood sugars.

All diabetics need to seek pre-conception counseling before getting pregnant.

If you are interested, I have a 30 day course for gestational diabetes.

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Cognitive Behavior Weight Loss

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Change your thinking and change your life. Your life is a result of your daily decisions. Perceptions can be changed with a single thought. You must believe that cognitive behavior weight loss is indeed possible. What does that mean? Keep reading…

What is your motivation?

What is your motivation to change your life? When you reach the point where your weight is unacceptable, you will make changes in your lifestyle.

To make sustainable lifestyle changes you must:

  1. Change your thinking
  2. Manage your environment
  3. Take a long-range view

As a diabetes care and support manager, I am trained in how to maintain sustainable changes in your life. What does sustainable mean? It means that you can continue it on an ongoing basis. Diabetes is directly related to excess weight. It is a chronic disease, so it is important to manage your weight gain over a lifetime, therefore, by sustainable means.

We have all tried to lose weight on diets. We can deny ourselves for a while, but we give up and go back to our old eating habits. Then we feel like failures.

We need to change our thinking by identifying your why and focusing on it every day. Have you taken the time to evaluate what motivates you? That is the first step.

Be realistic

Be realistic! When you go on a low carb diet, you are going to crave carbohydrates. Your body’s main fuel supply is carbohydrates. So when you reduce your carbs, you feel tired. But carbohydrates are not your enemy.

There are limits to our energy to deny what we crave. Don’t try to change all your bad eating habits at the same time. Make a list of your cravings and prioritize them.

Pick one to focus on. For example, potato chips. Look at the serving size and measure out one serving. Put the chip bag away. Enjoy your one serving of chips once a day. Celebrate your ability to control your cravings. When this is an automatic behavior, pick another one or two on your list. Don’t try to deny all your poor eating habits at the same time.

Manage your environment – Plan ahead.

Out of sight = Out of mind

Make it harder to do what is bad. You are going to get hungry. Set a bowl of fruit or nuts where you can see them and put away the bag of chips. When you are hungry, eat the fruit.

Another way is to not purchase the bag of chips, thereby controlling your environment.

In-sight = in mind

Plan for healthy snacks like yogurt or cheese sticks. Keep in mind sweet snacks are digested quickly leaving you hungry again. Snacks with high fiber like nuts and seeds or protein snacks protect against hunger longer. Plan ahead for your snacks and stick to it.

Plan ahead for non-food rewards

I encourage everyone to journal daily. Record your successes and reward yourself with non-food items. Consider a massage, a date night, maybe even a trip. There are a wide variety of ways to reward yourself with non-food items. Celebrate your victories!

Write about your failures. You will have failures. It is important to take time to evaluate what went wrong. Learn from your failures.

Take a long-range view – expect setbacks

Record in your journal your feelings. Many people do not have good coping skills. If you have a bad day, know that tomorrow is a new opportunity. Forgive yourself and learn from your setbacks. Research healthy ways to cope with stress. Practice what works best for you. Promise yourself to try harder tomorrow.

Focus on the times when things went right. Celebrate your victories. Each evening (maybe when you are watching television) review your day and journal your successes. Feel good about your progress. Having a written record is important to remember your growth. Your journal will help you realize how much you have grown.

Cognitive behavior weight loss

My 30-day program emphasizes cognitive-behavioral dieting. There are many tricks to making sustainable changes. Previously I suggested journaling while watching television. This is called stacking habits.

Stacking habits is setting up cues for remembering healthy habits. My 30-day program supports you in making sustainable lifestyle changes. Check it out under my programs tab, or click the link below for more info and to join.

Click here for more info about my 30-day program and to join!

If you know of anyone who could benefit from cognitive behavioral dieting, be a good friend and share this blog post with them! If you have questions that aren’t answered here, you can email me at Julie@kidsatriskfordiabetes.com.

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