Gestational Diabetes Mellitus
We all know that Bedrest is difficult, but did you know that certain complications that cause mamas to be put on bed rest can also put mamas at risk for heart health problems later in life?
In today’s post, I am sharing with you an info graphic from the California Maternal Quality Care Collaborative (CMQCC) which outlines the potential cardiovascular (heart) risks that Mamas on Bedrest are exposed to as a result of certain pregnancy complications. The purpose of sharing this info graphic is not to scare you, depress you about being on bed rest or to add more stress to an already difficult situation. Rather, my motive is to make you aware of future health risks, to educate you and share information with you so that you can take the best care of yourselves now, during your pregnancies, and throughout the rest of your lives.
The CMQCC infographic specifically names Pregnancy Induced Hypertension, Pre-Eclampsia, HELLP Syndrome, Gestational Diabetes and Preterm Births all as increasing a mama’s risk of developing heart disease later in life. We know this because of information shared in previous blog posts on Peripartum Cardiomyopathy, Pre-Eclampsia, and Gestational Diabetes.
But I really like this infographic because it gives a lot of information in a neat, concise and readable fashion. I think the infographic is easy to follow and mamas can get all the information that they need at a glance. Then if mamas desire more information, they can read the additional resources provided in this post and in the resources in the infographic at their leisure.
This is great information, Mamas. Do take the time to read it. Got Questions? Ask them on our live Free Q & A teleseminar this Thursday! I, Bedrest Coach Darline Turner, will be answering all bed rest related questions, including those related to this infographic. While I can’t offer specific medical advice, I can steer you in the right directions to get all the information you need to make wise health care choices!
I presented the Teleseminar yesterday, “Do You or Don’t You Need Vitamin D”, and I have to say that I was blown away by all that I learned in researching the topic. The role of Vitamin D in overall health is still under investigation, but what I found in my research to be the general consensus is this:
- Vitamin D is important in that is aids in the intestinal absorption of Calcium, Iron, Magnesium, phosphate and zinc.
- Vitamin D does not appear to “cure” anything, but in “adequate levels” in the blood, it seems to augment many bodily systems and functions so as to help ward off disease
- Vitamin D levels need to be at the recommended levels all the time and before illness begins to be of most benefit.
- Adequate Vitamin D levels definitely improve bone health in conjunction with adequate calcium levels.
- Adequate Vitamin D levels in Pregnancy seem to prevent pre-eclampsia and preterm labor. Low levels are associated with Gestational Diabetes, Pre-eclampsia and Low birth weight in infants.
- Most vitamins on the market don’t contain enough Vitamin D, including most prenatal vitamins. The Institute of Medicine recommends that adults take 2000IU-4000IU Vitamin Daily. Most vitamins contain 600IU
- The Institute of Medicine and the March of Dimes both recommend that pregnant women take 4000IU of Vitamin D Daily
- Target blood levels are 50 nmol/l according to the Institute of Medicine. However, the International Osteoporosis Foundation recommends that individuals with risk factors for osteoporosis aim for blood levels around 75nmol/l.
- Dark-skinned people are more likely to be Vitamin D deficient because the melanin in our skin does not allow in the sun rays needed to convert cholesterol to Vitamin D in the body. Dark Skinned people should take a Vitamin D supplement because as on researcher said, “Black and brown people are urged to take Vitamin D supplements. There is very little potential risk for harm and the potential benefits are significant.”
I first had my Vitamin D level checked in 2009 when I was feeling awful and my doctor was trying to figure out why I was so tired and listless. At that time, my Vitamin D level was 23 nmol/l, well below the recommended 50 nmol/l. I have been taking Vitamin D ever since and now have a level of 53 nmol/l, down from my last year’s check up of 59 nmol/l. And I have to admit, I have been feeling good and some days, “I just didn’t get around to taking my vitamins”. Well, the dip in my Vitamin D level and learning all of this research has made a believer out of me!
This whole debate really got me thinking. I don’t know how long I had been Vitamin D deficient, but according to what I have read, it may be for most of my life given that I am a dark-skinned black woman born and raised in Massachusetts. As it relates to pregnancy, I wonder if my low Vitamin D levels have anything to do with me developing uterine fibroids? One of the effects of low vitamin D in pregnant women is preterm labor which seems to be due to uterine irritability and/or placental inflammation. Well, fibroids certainly were irritating my uterus! Lost a pregnancy before having them out. Then got pregnant with my daughter and had some spotting, “cramping” (which I now know was preterm contractions) and ended up delivering her at 36 weeks and 6 days at 5 lbs 3 oz (low birth weight). If I had started taking Vitamin D at age 29 when I was first diagnosed with fibroids, would I have had the problems with my uterus/fibroids? Would I have had the miscarriage? Would my daughter have been born early and small?
I know that there are far too many variables to even make this a plausible argument. Likewise, my daughter is now 11 and I had a healthy term baby after her (well, actually after a second miscarriage!). So would Vitamin D have made a difference? I’ll never know. But it’s like the researcher alluded, Taking Vitamin D would not have hurt me and most likely would have helped me. I can’t take back what happened as I was childbearing, but I can and will regularly take 4000 IU Vitamin D daily to keep my immune system working “happily” (there is some talk that a happy immune system is “immune” to developing cancer!), to keep my bones strong and to lower my risk of falls, to ward off autoimmune diseases and to help stave off Diabetes.
Mamas, I am sure that many of you are unsure of whether or not to take vitamin D supplements. Discuss these findings with your doctor or a nutritionist. The evidence is mounting that taking Vitamin D supplements is a good thing for most people. Find out if its a good thing for you! There isn’t much if any risk of injury or harm, and yet taking Vitamin D can do much to improve your overall health. Investigate this for yourself!
I am working on the recording and will make it available soon. If you have questions or comments about Vitamin D, ask me in the comments section below. I have compiled a lot of information and a great resource for Vitamin D supplements and will gladly share!
While Gestational Diabetes Mellitus (GDM) is a less frequent reason for being prescribed Bedrest, GDM can significantly complicate pregnancy as well as maternal and fetal health. Close management of GDM and tight control of blood sugars is essential for best pregnancy outcomes.
In the August issue of Obstetrics and Gynecology, researchers report that new studies comparing single step and 2 step GDM screening indicate that 2 step screening, which is the current course of screening in the US, is still the preferred method of care. Many other countries use the single step method, but ACOG researchers feel more researcher needs to be done before recommending changing screening protocols.
The two step screening process requires pregnant women between 24 and 28 wks gestation drink a 50gm glucose solution followed by blood glucose levels taken one hour later. If a woman’s blood sugar levels are elevated, the test is repeated using a 100gm solution and blood levels drawn 3 hours later. If the second test comes back elevated, the woman is diagnosed with GDM and started on dietary management first, than oral medications and/or insulin injections are added if necessary to reach and maintain proper blood sugar levels.
According to ACOG’s report, 4 million American women give birth annually and 7% will develop GDM. GDM complicates pregnancy by putting mamas at increased risk of pregnancy induced hypertension, pre-eclampsia, c-section delivery and developing Type II Diabetes later in life. Infants born to mothers with GDM are at risk of macrosomia (being large for gestational age), hypoglycemia, birth trauma and c-section delivery.
GDM is a relatively common occurrence during pregnancy and is on the rise with the national rise in obesity and mamas delaying pregnancy until later in life. ACOG reaffirming it’s recommendation for the 2 step GDM screening procedure goes far in detecting GDM early and starting treatments as soon as possible when needed.