GMD - Gestational Diabetes Mellitus Helping Your Client...

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Pat Sonnenstuhl,ARNP, CNM 1 Gestational Diabetes Mellitus Helping Your Client Make Healthy Lifestyle Choices
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Pat Sonnenstuhl,ARNP, CNM 2 Introduction Following appropriate screening guidelines, understanding causation and associated conditions, and effectively managing the client with GDM can improve both short term and long term health conditions associated with GDM
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Pat Sonnenstuhl,ARNP, CNM 3 Definitions Gestational Diabetes (GDM ) Insulin Resistance (IR) Glycemic Index (GI) Syndrome X Body Mass Index (BMI)
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Pat Sonnenstuhl,ARNP, CNM 4 Gestational Diabetes (GDM ) A carbohydrate intolerance of varying degrees and severity with onset or first recognition during pregnancy with a probable resolution after the end of pregnancy. Diabetes, glucose intolerance or insulin resistance may have existed before the pregnancy. GDM is not the same as Type 1 or Type 2 Diabetes
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Pat Sonnenstuhl,ARNP, CNM 5 Insulin Resistance (IR) Insulin resistance is the resistance of the skeletal muscles and adipose to the affects of insulin. The pancreas produces more insulin, and over time cells become more and more resistant to the actions of insulin. As blood sugars and insulin increase, eventually the pancreas fails to produce enough insulin and diabetes occurs.
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Pat Sonnenstuhl,ARNP, CNM 6 Glycemic Index (GI) The glycemic index ranks foods on how they affect our blood sugar levels. This index measures how quickly an individual's blood sugar increases in the two or three hours after eating. http://www.mendosa.com/gi.htm
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Pat Sonnenstuhl,ARNP, CNM 7 Factors That Affect the GI The GI of a food is influenced by the characteristics of the food or meal. Processing, preparation, storage, physical form, and ripeness of foods affect the GI. The GI varies within the same individual and between individuals.
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Pat Sonnenstuhl,ARNP, CNM 8 Value of the GI Each client can determine how she reacts to certain foods by monitoring food intake and postprandial blood glucose levels The primary goal of GDM management is to achieve and maintain euglycemia throughout pregnancy to improve the outcomes for both mother and fetus
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Pat Sonnenstuhl,ARNP, CNM 9 Syndrome X The loss of responsiveness of the body to insulin is associated with a ‘clustering’ of cardiovascular risk factors that includes abdominal obesity, hypertension, dyslipidemia, glucose intolerance and hyperinsulinemia. This association is referred to as the insulin resistance syndrome , which is also known as Syndrome X .
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Pat Sonnenstuhl,ARNP, CNM 10 Body Mass Index (BMI) A commonly used measure to differentiate underweight, normal weight, overweight and obesity. Obtained by dividing the weight of the subject (in kilos) by the square of his (her) height in meters.
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