Briefly, when diabetes occurs during a woman’s pregnancy, it’s known as Gestational Diabetes.
We think that it caused by the change in hormone levels, but also by the additional weight gain that occurs. This combination of factors affects the woman's blood sugar and her body's ability to use insulin. The blood glucose levels increase and the amount of insulin available is not sufficient.
Insulin Resistance
We think that for some pregnant women, insulin resistance occurs also plays a role. In that scenario, the food that a woman eats is metabolized into blood sugar. Insulin's job is to help transport blood sugar from the circulation into the cells. When there is an insulin resistance, it's much harder for the insulin to move the glucose into the cells.
Higher levels of blood sugar, also known as blood glucose, can have harmful effects on both mom and baby.
I learned this nifty trick from some pretty astute and experienced pre-school teachers. Instead of teaching children to cough and sneeze into their hands, teach them to turn their heads and sneeze or cough into the inside of their elbows.
Brilliant!
This helps prevent them from spreading germs to their hands which they’re much more likely to use to swipe across other people or other surfaces than their elbows.
There’s also a nifty soap out there, Squid Soap that helps teach children and grown ups how to wash their hands for 90 seconds. Here’s a video.
This is a guest blog by my friend and fellow nurse practitioner, Jenny Jin.
It is 7AM in the Kaiser Santa Clara Cardiac Procedure Unit. This is the place where people have Coronary Angiography. A scary sounding procedure that helps diagnose heart disease and look for clogging in the coronary arteries. These are the tiny blood vessels that bring oxygen and nutrients to the heart muscle. If they don’t work right, the heart doesn’t work right.
During the test, if there’s life-threatening obstruction, we can intervene with various tools to dilate and open up arteries that may have been blocked, allowing more blood flow to the heart. The nurses are bustling to get their anxious patients ready for their upcoming procedures. This is where I come in, to help prepare patients and their families for the procedure. I wind my way through the unit, talking to each patient, obtaining a thorough history and then performing a physical exam. This is the time I can answer questions from the patients and their families. After a while, patients are relaxed enough to joke around a little bit, some even to call us “plumbers of the heart”.
A while back I started a series on PCOS. You can read parts 1, 2 & 3 and the post on treatment if you'd like. Today we'll talk about weight control, which is a challenge for many women with PCOS.
Quick Review
Most women with PCOS also have difficulty losing weight and keeping weight off, which is not their fault and completely unfair. Because of the imbalance of hormones, they also have an underlying Insulin Resistance, in simplified terms means that they are more likely to gain weight.
How this happens:
Eating starches and carbohydrates makes blood sugar.
Insulin helps transport blood sugar into muscle, fat and liver cells.
With Insulin Resistance, there are lots of roadblocks to this transport.
This leads to higher blood sugar levels.
It also causes more fat to develop, especially around the waist area.
This can lead to Type 2 Diabetes.
Nutrition recommendations
It's a good idea to ask your provider to check your fasting glucose level and cholesterol & triglycerides in a Lipid panel. If you can see a nutritionist, that's even better.
Most women with PCOS will be able to lose and maintain their weight if they restrict their carbohydrates with a diet much like South Beach. Some start from the beginning if they want to lose weight, others use the 2nd phase or maintenance plans to control their weight.
My patients have found that limiting carbohydrates not only helps with their weight loss, but also improves their triglyceride & cholesterol levels.
Too often, we learn of someone who is desperately seeking a Bone Marrow Match to treat their leukemia or other bone marrow cancer. Recently I met Yul Kwon, he was one of the winners of Survivor. He's actively involved in educating people about bone marrow drives, particularly in the Asian American community.
When I worked in pediatric intensive care at Stanford, one of the most heart breaking experiences I encountered was working with children who were waiting for a bone marrow match. I'm passing on this information in case any of you know of someone who might fit the criteria. Please pass this on to as many people as possible.
Mom of 3 needs a bone marrow match
My friend, a local mother of three and elementary school teacher, is fighting for her life. In January 2008, she was diagnosed with acute myelogenous leukemia (AML), the same leukemia I battled. After five rounds of intensive chemo, her cancer returned. It was then doctors found she had been misdiagnosed and was actually fighting acute lymphoblastic leukemia (ALL). Because she has received so much chemo already, her body will not handle the normal course of treatment for ALL.
She needs a bone marrow transplant to save her life. And she needs it soon. Currently there is no match for her on the national donor database or on international databases. She is looking for someone of Native American AND German ancestry. The percent of each heritage is not important.
Two action items:
1.If you fit this description and are willing to help, would you please contact me? You must be between 18 and 60 and healthy to give. You can be tested for free via a simple cheek swab you can do at home.
2.If you don’t fit this description, could you please forward this email to others? I’m convinced there’s a donor out there. We just need to cast the net wide enough.
