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Gestational Diabetes Education For Patients

Reducing Barriers To Glucose Control In Patients With Gestational Diabetes

Reducing Barriers To Glucose Control In Patients With Gestational Diabetes

Reducing barriers to glucose control in patients with gestational diabetes Author: Preventing adverse outcomes may hinge on your ability to identify and overcome barriers that prevent some pregnant women from managing their diabetes properly. According to the Centers for Disease Control and Prevention (CDC), 9.2% of pregnant women develop gestational diabetes mellitus (GDM) as a serious complication during pregnancy. A positive glucose tolerance test in the second trimester can be a shock for an expectant woman. Poor glucose control can lead to poor outcomes for both mother and fetus. A woman carrying a large fetus is more likely to require surgical delivery and faces a longer recovery. Whats more, although GDM usually goes away after delivery, it increases the womans risk for developing type 2 diabetes later in life. For the fetus, placental glucose permeability causes extra fat storage; the fat fetus is at high risk for delayed lung development, premature delivery, and hypoglycemia immediately after birth. Also, the fetus stands a higher chance of suffering shoulder trauma during natural labor. A pregnant woman needs time and effective mechanisms to cope with the diagnosis of GDM and the lifestyle changes shell need to make. But the sooner she starts controlling her blood glucose, the lower the odds that GDM will harm her or her fetus. Nurses working with women who have GDM can help reduce negative outcomes by using the nursing process to assess the patient for barriers to managing GDM and achieving good glycemic control. The most common barriers are: patients lack of knowledge about diabetes and its long-term effects on the mother and fetus patient nonadherence, such as difficulty self-monitoring blood glucose because of the need for multiple blood samples and compl Continue reading >>

Resources: Diabetes In Pregnancy

Resources: Diabetes In Pregnancy

Within this page are a variety of resources and links to downloads that you can use professionally and to assist your patients. First are items from SSEP,including archieved newsletters, see the product websitepage for professional and patient materials. Second, many resources (both for porfessionals and patients) fromCDAPP (California Diabetes and Pregnancy Program) are listed. To follow next arepublished standards in the care of Diabetes and Pregnancy. Finally, there are numerous free resources and patient materials on a variety of subjects. These are listed alphabetically by the resource group or subject. Direct website links and download linksare provided when available: click onunderlined or buttons below. Diabetes & Pregnancy Self-Study Modules - 40 CE Credits. Online format - [email protected] Details for all professional and patient resourceson the product page. Birth Defect Research for Children, Inc. (BDRC) is a 501(c)(3) non-profit organization that provides parents and expectant parents with information about birth defects and support services for their children. BDRC has a parent-matching program that links families who have children with similar birth defects. The Compliance Scale developed by Susan Rasmussen, RN and Colleen Johnson, RD who manage the Perinatal Outpatient Services/Sweet Success Program at Sierra Vista Regional Medical Center in San Luis Obispo, California, may be downloaded and copied. The objective of this compliance scale is to provide the Healthcare Provider with accurate and measurable information regarding a patient's participation in the program. For more information, contact Susan directly [email protected] Promotes the benefits of public cord blood banking and provides the latest up-to-date information Down Continue reading >>

Patient Education: Gestational Diabetes Mellitus (beyond The Basics)

Patient Education: Gestational Diabetes Mellitus (beyond The Basics)

INTRODUCTION Insulin is a hormone whose job is to enable glucose (sugar) in the bloodstream to enter the cells of the body, where sugar is the source of energy. All fetuses (babies) and placentas (afterbirths) produce hormones that make the mother resistant to her own insulin. Most pregnant women produce more insulin to compensate and keep their blood sugar level normal. Some pregnant women cannot produce enough extra insulin and their blood sugar level rises, a condition called gestational diabetes. Gestational diabetes affects between 5 and 18 percent of women during pregnancy, and usually goes away after delivery. It is important to recognize and treat gestational diabetes to minimize the risk of complications to mother and baby. In addition, it is important for women with a history of gestational diabetes to be tested for diabetes after pregnancy because of an increased risk of developing type 2 diabetes in the years following delivery. More detailed information about gestational diabetes is available by subscription. (See "Diabetes mellitus in pregnancy: Screening and diagnosis".) GESTATIONAL DIABETES TESTING We recommend that all pregnant women be tested for gestational diabetes. Identifying and treating gestational diabetes can reduce the risk of pregnancy complications. (See "Diabetes mellitus in pregnancy: Screening and diagnosis".) Complications of gestational diabetes can include: Having a large baby (weighing more than 9 lbs or 4.1 kg), which can increase the risk of injury to the mother or baby during delivery and increase the chance of needing a cesarean section. Stillbirth (a baby who dies before being born), a complication which fortunately is now rare in women with gestational diabetes because of good control of blood sugars and careful monitoring of mo Continue reading >>

Diabetes In Pregnancy

Diabetes In Pregnancy

Gestational diabetes refers to diabetes that is diagnosed during pregnancy. Gestational diabetes occurs in about 7 percent of all pregnancies, usually in the second half of the pregnancy. It almost always goes away as soon as your baby is born. However, if gestational diabetes is not treated during your pregnancy, you may experience some complications. Causes Pregnancy hormones cause the body to be resistant to the action of insulin, a hormone made by your pancreas that helps your body use the fuels supplied by food. The carbohydrates you eat provide your body with a fuel called glucose, the sugar in the blood that nourishes your brain, heart, tissues and muscles. Glucose also is an important fuel for your developing baby. When gestational diabetes occurs, insulin fails to effectively move glucose into the cells that need it. As a result, glucose accumulates in the blood, causing blood sugar levels rise. Diagnosis Gestational diabetes is diagnosed with a blood test. Your blood glucose level is measured after you drink a sweet beverage. If your blood sugar is too high, you have gestational diabetes. Sometimes one test is all that is needed to make a definitive diagnosis. More often, an initial screening test is given and, if needed, a longer evaluation is performed. Gestational diabetes usually does not occur until later in pregnancy, when the placenta is producing more of the hormones that interfere with the mother's insulin. Screening for gestational diabetes usually takes place between weeks 24 to 28. However, women at high risk are usually screened during the first trimester. Risk Factors There are a number of risk factors associated with gestational diabetes, including: Being overweight Giving birth to a baby that weighed more than 9 pounds Having a parent or siblin Continue reading >>

Gestational Diabetes

Gestational Diabetes

During pregnancy, some women develop high blood sugar levels. This condition is known as gestational diabetes mellitus (GDM). GDM typically develops between the 24th and 28th weeks of pregnancy. According to the Centers for Disease Control and Prevention, it’s estimated to occur in up to 9.2 percent of pregnancies. If you develop GDM while you’re pregnant, it doesn’t mean that you had diabetes before your pregnancy or will have it afterward. But GDM does raise your risk of developing type 2 diabetes in the future. If poorly managed, it can also raise your child’s risk of developing diabetes and add other risk factors to you and your baby during pregnancy and delivery. It’s rare for GDM to cause symptoms. If you do experience symptoms, they will likely be mild. They may include: fatigue blurred vision excessive thirst excessive need to urinate The exact cause of GDM is unknown, but hormones likely play a role. When you’re pregnant, your body produces larger amounts of some hormones, including: human placental lactogen estrogen hormones that increase insulin resistance These hormones affect your placenta and help sustain your pregnancy. Over time, the amount of these hormones in your body increases. They may interfere with the action of insulin, the hormone that regulates your blood sugar. Insulin helps move glucose out of your blood into cells, where it’s used for energy. If you don’t have enough insulin, or you have high levels of hormones that prevent insulin from working properly, your blood glucose levels may rise. This can cause GDM. You’re at higher risk of developing GDM if you: are over the age of 25 have high blood pressure have a family history of diabetes were overweight before you became pregnant have previously given birth to a baby weighin Continue reading >>

Gestational Diabetes Mellitus

Gestational Diabetes Mellitus

Setting up a Pharmacist-Run GDM Education Service A pharmacist interested in developing a GDM education service must first assess the feasibility of providing such education in his or her practice setting. A private area with no distractions is necessary for one-on-one patient counseling. The pharmacist should also determine whether such a program is needed in the practice setting. This assessment can be completed by talking with local physicians, clinic administrators, and patients. If a GDM education service is feasible and needed, the pharmacist must develop a curriculum. Well-established guidelines can be adapted to educate patients with GDM. Table lists the points that should be covered by an educational program according to ADA.[ 27 ] The pharmacist must also market the service to local physicians and clinics in order to obtain patient referrals. Depending on budgetary and time constraints, marketing can range from mailing letters or fliers to the medical staff to providing inservice sessions about GDM. The pharmacist should stress that the program is intended to support the team involved in caring for these patients, not to be a replacement for current care. As patients are referred, a medical record should be established that includes relevant patient data, education received by the patient, and questions asked by the patient. If blood glucose testing is performed during the educational visit, the result of that test should be recorded, along with the dates of any follow-up appointments. At the end of the session, a letter summarizing all this information should be sent to the referring physician. Assuming that there is an established patient care or private counseling area in the location where the education is to take place, start-up costs are minimal, with t Continue reading >>

When You Have Diabetes During Pregnancy

When You Have Diabetes During Pregnancy

You have just been told that you have gestational diabetes. You may have some concerns and worries. It's natural to feel confused and challenged by this diagnosis, but many people are ready to help and support you. Have your health care provider or diabetes educator provide you with the names and phone numbers of people who can help. Write this information on the inside front cover of this book. Remember: many women have gone through this and given birth to healthy babies! When untreated, gestational diabetes can be serious. When treated, complications can be managed and prevented. For many women, gestational diabetes can be managed by following a meal plan, exercising as recommended, lowering stress, and monitoring blood glucose levels. Some women will also need to have insulin injections. Naturally, this can all sound overwhelming at first. Careful and regular monitoring from your health care provider, education about gestational diabetes, and this online information all will help you understand: what's happening to your body how gestational diabetes is affecting you and your baby how it can be controlled For many women, gestational diabetes can be managed by: You're not alone Remember, many women with gestational diabetes have given birth to healthy babies. Many people are ready to support you. Have your health care provider give you the names and phone numbers of people who can help. Write this information on the resource worksheet. Forms and worksheets Continue reading >>

A Guide To Gestational Diabetes

A Guide To Gestational Diabetes

This page by no means replaces the treatment that you should seek from your health care team. Diabetes and pregnancy require a program of treatment individualized to you and your baby. What is gestational diabetes? Gestational diabetes is glucose intolerance that is diagnosed between 24 and 28 weeks of pregnancy. Glucose intolerance means a problem in the body’s usual process for changing the glucose (sugar) from food into energy. Normally, the pancreas makes insulin that carries the glucose into the cells. The extra glucose is stored in muscle, liver, and fat cells. When you’re pregnant, the placenta makes hormones that work against the body’s insulin. During pregnancy, the body needs three to four times as much insulin as it usually does. In gestational diabetes, the body’s insulin supply cannot keep up with the need. The extra glucose stays in the blood and crosses the placenta to the baby. Who gets gestational diabetes? Gestational diabetes occurs in about 7 percent of all pregnancies. Your chances of developing gestational diabetes are greater if you: Have a family history of diabetes Are overweight Have had a baby weighing more than 9 pounds at birth Have had a stillbirth Are of an ethnic origin at increased risk for Type 2 diabetes, such as Native American, African American, or Hispanic However, gestational diabetes can occur even with no risk factors. How is gestational diabetes diagnosed? It is important to detect and treat gestational diabetes early so that the developing baby is not affected. If you are at high risk for diabetes, you will be tested early in pregnancy. All women, regardless of risk, should be screened for gestational diabetes by taking an oral glucose tolerance test between 24 and 28 weeks of pregnancy. This should be done in the morni Continue reading >>

Gestational Diabetes

Gestational Diabetes

4% of pregnant women will develop gestational diabetes. After the pregnancy is over, most women will have normal blood sugars again; however, they remain at risk for diabetes. Gestational diabetes refers to diabetes diagnosed during pregnancy. The Center for Disease control estimates that up to 9.2% of pregnant women will develop gestational diabetes. Pregnancy hormones can interfere with the way insulin works in the mothers body which can lead to elevated blood glucose levels during pregnancy. Women are typically screened for gestational diabetes at 24-28 weeks of pregnancy, however women who have risk factors may be screened earlier. Risk factors for developing gestational diabetes include having a family history of diabetes, being overweight, or over25 years old. Women who areblack, Hispanic, American Indian or Asian are more likely to develop gestational diabetes. Blood glucose controlduring pregnancy is critical as elevated maternal glucose levels can lead to pregnancy complicationsand poses risks to the health of the baby. Gestational diabetes is likely to recur during subsequent pregnancies. Gestational diabetes requires specialized treatment for the rest of the pregnancy. After the pregnancy is over, most women will have normal blood sugars again; however, up to 20-50 % will develop type 2 diabetes within 10 years. Regular screening is recommended. The best prevention strategy is to eat healthy, control weight, and stay active. Continue reading >>

Diabetes In Pregnancy Program

Diabetes In Pregnancy Program

The Center for Perinatal Care offers specialized care management for women with diabetes. Our Diabetes in Pregnancy Program helps women with all types of diabetes to obtain glucose control before conception, during pregnancy and after delivery. Successful diabetes management is reached through open communication, frequent contact and the dedication of both patient and provider. Patients have direct access to providers through individual appointments, direct telephone encounters, MyUnityPoint (MyChart), as well as group classes. Each woman's care is tailored to her needs and goals with cutting edge strategies. Our program uses the best and most up-to-date resources for glucose monitoring, insulin delivery and glucose control. Our Certified Diabetes Educator is an advanced practice nurse who works with each patient to develop an individualized plan for diabetes management. We are dedicated to helping women find strategies to meet their goals. Having a baby and deciding to become a parent is a big decision. Most women with diabetes have healthy babies, but pregnancy can be a challenging time for the woman with diabetes. Insulin needed during pregnancy varies and increases throughout pregnancy. It is important that glucose levels be in a normal range to reduce the risk of complications to mother and baby. Getting the right facts about pregnancy and diabetes is vital to reduce the risk of problems and to anticipate the demands of a high-risk pregnancy. Learning about the care that is involved for diabetes during pregnancy can help women make informed decisions about when to have a baby, how to plan for a healthy pregnancy, and what to expect during pregnancy. The Diabetes in Pregnancy Program helps women greatly reduce the risk of problems during pregnancy. We recommend pre Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is the occurrence of diabetes during pregnancy, when hormones cause the body to become resistant to insulin, leading to higher blood sugar levels. Most women without known diabetes are screened for gestational diabetes during pregnancy. There is an important difference between pregnancies in women who were diagnosed with diabetes prior to pregnancy (preexisting Type 1 or Type 2 diabetes) and those diagnosed during pregnancy when blood sugar tends to rise in response to hormones (Gestational diabetes). Learn more about pre-pregnancy planning for women with diabetes . Gestationaldiabetes often goes away after childbirth, butwomen who have had gestational diabetes are far more likely than other women to developtype 2 diabetes. You may be able to prevent or delay type 2 diabetes by maintaining a healthy weight, eating healthy foods, and increasing your physical activity. U-M offers several support classes for Gestational Diabetes . The pancreas makes a hormone called insulin. Insulin helps your body properly use and store glucose extracted from the food you eat, keeping your blood sugar level within a safe range. When you are pregnant, the placenta produces hormones that can make it harder for insulin to work. This is called insulin resistance. Because gestational diabetes does not cause symptoms, you need to be tested for the condition. This is usually done between the 24th and 28th weeks of pregnancy.You may be surprised if your test shows a high blood sugar. It is important for you to be tested for gestational diabetes, because high blood sugar can cause problems for both you and your baby. How is diabetes treated during pregnancy? All pregnant women with diabetes need to check their blood sugar. Many women with gestational diabetes can control thei Continue reading >>

Gestational Diabetes Education Clinic

Gestational Diabetes Education Clinic

What happens at my first visit to this clinic? You will see the dietitian and the diabetes educator (who is also a midwife). They will discuss the following with you: What Gestational Diabetes Mellitus (GDM) is. How to test your blood glucose levels at home. How to adapt your diet and exercise levels to help manage your blood glucose levels. Your current antenatal clinic appointments will be cancelled and a new schedule of appointments booked for the clinic: Gestational diabetesdiet management. Who will I see for the management of my gestational diabetes? At your follow-up visit (one week later) you will see an obstetrician. At this visit they will check both you and your baby. They will also review your blood glucose levels. My blood glucose levels are in the normal range If your blood glucose levels are within the normal range you can continue to use the new appointment schedule, given to you the previous week, for the clinic: Gestational diabetesdiet management for the remainder of your pregnancy. This team includes midwives, dietitians, obstetricians, registrars and obstetric physicians; although you may not see all of these people each visit. If your blood glucose levels are raised you will be asked to see the obstetric physician; they will plan your ongoing care with you. This may include starting medication to assist in reducing your blood glucose levels. You will also be given a new appointment schedule for the clinic: Gestational diabetesmedication management where you will see the specialist GDM team for the remainder of your pregnancy. This specialist clinic team includes midwives, dietitians, obstetricians and obstetric physicians. Although you may not see all of these people each visit, you will have regular visits with the obstetric physicians. Mater ackn Continue reading >>

The Challenges Of Providing Diabetes Education In Resource-limited Settings To Women With Diabetes In Pregnancy: Perspectives Of An Educator

The Challenges Of Providing Diabetes Education In Resource-limited Settings To Women With Diabetes In Pregnancy: Perspectives Of An Educator

The Challenges of Providing Diabetes Education in Resource-Limited Settings to Women With Diabetes in Pregnancy: Perspectives of an Educator 1Riddle Hospital/Main Line Health System, Media, PA 2Community Volunteers in Medicine, West Chester, PA Author information Copyright and License information Disclaimer Copyright 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details. IN BRIEF In resource-limited settings, the challenges of providing diabetes education are magnified. To provide the best education, these challenges and barriers need to be identified and addressed. Many times, at the teachable moment of a gestational diabetes diagnosis, we are able to not only address the immediate concerns, but also help patients adopt and continue long-term healthy lifestyle behaviors that improve the health of their entire family. There are special challenges in delivering gestational diabetes care and education in low-resource settings. These include limited access to care, the potential for lower literacy and health literacy levels, and language, cultural, social, and financial barriers. It is important that all of these obstacles be recognized and addressed as needed. After a woman has been diagnosed with gestational diabetes mellitus (GDM) at her obstetricians office in the Main Line Health System (MLHS) in southeastern Pennsylvania, she is referred to the diabetes center at one of the MLHS hospitals to meet with a certified diabetes educator (CDE). In one appointment lasting 90 minutes, three topics are covered: the pathophysiology of GDM, self-monitoring of blood glucose (SMBG), and meal planning. The population served in this system Continue reading >>

Gestational Diabetes

Gestational Diabetes

PDF Format Gestational Diabetes What is gestational diabetes? Gestational diabetes is diabetes mellitus that develops in women for the first time during pregnancy. Some women found to have gestational diabetes actually may have had mild diabetes before pregnancy that was not diagnosed. What is diabetes mellitus? Diabetes mellitus (also called "diabetes") is a condition that causes high levels of glucose in the blood (see the FAQ Diabetes and Women). Glucose is a sugar that is the body’s main source of energy. Health problems can occur when glucose levels are too high. What causes gestational diabetes? Gestational diabetes is caused by a change in the way a woman’s body responds to insulin during pregnancy. Insulin is a hormone. It moves glucose out of the blood and into the body’s cells where it can be turned into energy. During pregnancy, a woman’s cells naturally become slightly more resistant to insulin’s effects. This change is designed to increase the mother’s blood glucose level to make more nutrients available to the baby. The mother’s body makes more insulin to keep the blood glucose level normal. In a small number of women, even this increase is not enough to keep their blood glucose levels in the normal range. As a result, they develop gestational diabetes. Will I be tested for gestational diabetes? All pregnant women are screened for gestational diabetes. You may be asked about your medical history and risk factors or you may have a blood test to measure the level of glucose in your blood. This test usually is done between 24 weeks and 28 weeks of pregnancy. It may be done earlier if you have risk factors. If I develop gestational diabetes, will I always have diabetes mellitus? For most women, gestational diabetes goes away after childbirth. How Continue reading >>

Diabetes Management | Woman's Hospital Of Texas

Diabetes Management | Woman's Hospital Of Texas

The Womans Hospital of Texas is nationally recognized by the American Diabetes Association for quality self-management diabetes education. Our Perinatal Diabetes Center offers a variety of classes taught by certified diabetes educators, nurses and registered dietitians that are specifically designed to meet the needs of women with diabetes before, during and after pregnancy. Our Center partners with physicians, patients and staff to provide evidenced based instruction, support, updates, community activities and mentoring of student nurses and dietitians. We believe the future depends on the health of moms and babies. Education is imperative and pre-conception care is crucial. Everyone deserves a healthy start. Preconception Counseling: Planning Ahead (1-1 1/2 hour group or private class) Designed to help women with Polycystic Ovarian Syndrome (PCOS) and those with pre-existing diabetes to get a great start before they become pregnant. Discusses meal planning, exercise, blood sugar control, pattern management, and use of medications. Diabetes in Pregnancy (2 hour group class) This class instructs participants in the management of diabetes. It is intended for those newly diagnosed with gestational diabetes (GDM) or type 1 or type 2 diabetes with no prior educations. This class includes: meal planning a personalized meal plan is provided Glucose meter instruction where participants learn how to use their meter, how to perform quality control checks, and how to record and analyze glucose results (pattern management) over time for better diabetes management Discussion includes labor and delivery, infant feeding, postpartum issues, six-week blood glucose follow-up, and planning for future pregnancies. Advanced Management Concepts (2-2 hour private or group class) Get Pumped: Continue reading >>

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