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Dr. Jorge L. Diez, Dr Adarsh Jha
Paula Rocha APRN; Joan Schwartz,APRN
 Offices in Connecticut East Hartford, Enfield, Avon ,South Windsor and Glastonbury


Helpful Hints for Diabetics

 

What Is Gestational Diabetes?

A non-diabetic woman that develops high blood sugars during pregnancy has gestational diabetes. Gestational diabetes affects about 3 percent of all pregnant women, about 100,000 cases in the United States each year.

Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy. Glucose builds up in the blood to high levels (hyperglycemia). The American Diabetes Association says that all pregnant women should be screened for gestational diabetes between the 24th and 28th weeks (around the 6th month) of pregnancy. By then, the placenta has begun to make the hormones that lead to insulin resistance. The screening test measures the mother's blood glucose response to glucose consumed in a drink.

How Can Gestational Diabetes Affect My Baby?

Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels.

Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the glucose.

This can lead to macrosomia, or a 'fat' baby. Macrosomia develops because extra glucose and insulin cause the baby to make extra fat to use. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth.

Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.

 

Treating Gestational Diabetes

Because this condition can hurt you and your baby, you need to start treatment quickly. Treatment aims to keep blood glucose levels equal to those of pregnant women who do not have gestational diabetes.

Treatment always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections. Diabetic oral medications are contraindicated as some might hurt the development of your baby.

For the mother-to-be, treatment for gestational diabetes helps lower the risk of a cesarean section birth those very large babies may require. Sticking with your treatment will give you a healthy pregnancy and birth and help your baby avoid future health problems.

 

Keeping Worry in Perspective

While gestational diabetes is a cause for concern, the good news is that you and your health care team -- your doctor, obstetrician, and dietitian -- work together to lower your high blood glucose levels. And, with this help, you can turn your concern into a healthy pregnancy for you and a healthy start for your baby.

Driving Safety for Diabetics

 

Blood sugar levels as close to normal as attainable is one of the main goals of diabetic care. Nonetheless, keeping low blood sugar increases the risk of developing too low of a blood sugar, a condition that is known as Hypoglycemia. Hypoglycemia provokes cold sweats, rapid heartbeats, confusion, lightheadedness, and even fainting or coma. If recognized early it can be reversed easily by eating, or ideally drinking a sugar containing food, such as fruit juices or soft drinks.

Driving can be extremely hazardous during a period of hypoglycemia. Reflexes are slow, depth perception is impaired, and judgment fails. Police often stop diabetics experiencing hypoglycemia suspecting alcohol intoxication; some have been jailed when unable to explain their condition during the confusion caused by the hypoglycemia.

Hypoglycemic symptoms usually do not become apparent until blood glucose levels reach below 60 mg/dl (this is the measurement used by glucose meters). A study presented this month at the American Diabetes Association (ADA) showed that levels below 80 mg/dl could impair driving in some patients, a level higher than previously suspected.

Follow the following guidelines:

  • If you are prompt to hypoglycemia (especially type 1 diabetics) measure your blood sugar before driving.
  • If your blood glucose is below 80mg/dl do not get behind the wheel. Eat a moderate snack-containing simple and complex carbohydrates (bread, yogurt, crackers and juice) wait half an hour and re check.
  • Always carry glucose tablets in your car.
  • Pull over if you suspect your blood sugar is low and check your blood.
  • Carry with you a bracelet, medal, or card saying you are diabetic.
  • Never drive if you are missing a meal.
  • Plan stops at regular intervals during long trips, and check your glucose.
  • Follow a daily plan of care with guidelines from your diabetic team.

Drive safely. Happy trails.

 

 

 

 

Diabetes and your Weight

Most of us will do anything to improve our health and prolong our lives. We avoid dangerous foods, keep track of new developments in health maintenance, follow medications' instructions, etceteras. If you have diabetes you are probably watching your blood sugar and take your medications religiously. If you have high blood pressure, you watch your sodium intake, take antihypertensives, and follow an exercise regiment. Most of us have a different attitude regarding weight control.

Weight control could become the major health problem issue in the United States in the next decade as the "fast food" generation reach 50's and 60's, the decades when cardiovascular problems become common. Only some 15 or more pounds above ideal weight can increase your risk for heart disease, vascular disease, gastrointestinal problems, even colon cancer and cancer of the uterus to name a few.

Diabetics are particularly affected by above normal weight. Moderate weight problem increases the risk of some of the complications of diabetes, particularly cardiac and vascular problems. Insulin resistance increases with weight gain, making blood sugar control more difficult.

What can I do?

Weight control should become a daily habit for everyone. Even moderate weight losses are associated with heath benefits. Diabetics will find their blood sugars easier to managed, some could even stop taking medications. It will lower your blood pressure. It can prevent you from having a heart attack.

Moreover, weight control can improve your mental health, and improve your confidence and self esteem. And imagine you being able to use the clothes you have been saving in the attic for the past several years, or better yet, get a new wardrobe!

How I am going to lose weight?

Most good things in life are difficult to achieve, that is in part what make them desirable. Weight control can be very frustrating. In many studies only 5 people out of 100 will achieve and keep their weight loss for more than a year, in other words 95% of dieters will fail.

Why bother then? Because your health is at stake.

There are no simple rules in weight control. Successful weight loss requires determination and consistency. The first thing you should do is make up your mind that you are going to do it.

Once you have the right attitude then you should start looking at ways to control your food intake, that is choose and follow a diet. A diet can be as simple or as complicated as you like it to be, just be sure to review your plans with your physician prior to start any strict regiment. Better yet, ask your physician to set up an appointment with a nutritionist or dietitian.