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Home , Blood glucose monitoring

BRADEN CENTER

What if I Need Medication? If we are unable to keep your blood in the target ranges with diet and exercise, What is ? we may need to start you on medication. The Gestational diabetes is a type of of choice is . Oral medication which can occur during pregnancy and can be used, but insulin does not pass through usually goes away after the baby is delivered. the placenta so it is the preferred choice Gestational means “in pregnancy” and during pregnancy. diabetes means having more sugar in the Although women may feel hesitant to take blood than normal. medication when they are pregnant, the Having gestational diabetes does not mean greater risk is allowing the blood glucose your baby will be born with diabetes or birth to remain elevated. defects, but it does mean you may develop Exercise When 40 – 50% or more of the glucose results later in life. There are many health benefits to regular are over the target range in one week, medication will be considered. Please call us at any time exercise. One important benefit is it helps to Why is My Blood Sugar Too High? keep your blood glucose down. Exercise will if your fasting blood glucose is over 95 more also help you from gaining too much weight. than three times out of seven days, or if your • Your pregnancy hormones make it difficult • High blood glucose comes from the foods you While you are pregnant, it is important to: after meal glucose is greater than 140 more for your body to process the glucose (sugar) eat. Eating too many calories and eating too than four times in a week. We will discuss that comes from the food you eat. The body many carbohydrates can cause elevated blood • Choose an exercise that does not cause medication in more detail at that time. uses glucose for energy but the pregnancy glucose. The Dietitian will teach you to eat a you to bounce up and down. Walking and hormones may cause your blood sugar to diet with the right amount of calories and swimming are good choices. Does Gestational Diabetes Go Away? become higher than normal. carbohydrates to control your blood sugar. • • • Try to do some type of exercise 3 – 5 times/ • Once you delivery the baby your blood glucose Insulin is a hormone your body makes to lower Women are more likely to get gestational week for 30 minutes. Remember, a little should return to normal. your blood sugar and store glucose in your diabetes if they are: older mothers (over 25 exercise (10 – 15 minutes) is better than none cells. Your pregnancy hormones may not allow years), are overweight, have a family history at all. You may need to gradually build up • Your Obstetrician will schedule you for follow your body to use the insulin as well as it of diabetes, have quick or excessive weight your time. up lab work six weeks after delivery to check usually does. One reason insulin may not work gain during pregnancy, had a baby who to see if your blood glucose has returned well is extra body weight and extra body fat. weighed more than nine pounds in the past, are • Try your blood glucose before to normal. Be careful not to gain weight too quickly in of Hispanic, Asian, African, Native-American, and after exercise. This will let you know order to control gestational diabetes. and Pacific Islander background. how much exercise can assist in keeping • We will discuss steps for reducing your risk your blood glucose in a healthy range. of developing type 2 diabetes in the future.

• Avoid exercise if your blood glucose is too high or too low, during very hot weather, Targets recommended by the Braden Diabetes Center are based upon or if you are sick. the American Diabetes Association and American Association of Clinical Endocrinologists 2012 • Avoid lying on your back for exercise after the first trimester.

• Avoid exercising too hard. Talk with your doctor to know the level of exercise that is safe for you. Braden Diabetes Center 1100 South Eliseo Drive, Suite 2, Greenbrae, CA 94904 1-415-925-7370 | www.mymarinhealth.org

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MAR 48029 What Can Happen to My Baby Blood Glucose Monitoring and Me? • A blood and test supplies will • You will need to test your blood sugar four When the blood glucose levels go too high and be provided for you. times per day: first thing in the morning (as remain high, there is an increase for possible • Your blood glucose levels can change depending soon as you get up) and after your meals to risks to occur for both the mother and baby. on the foods you eat, how much exercise you be sure your blood glucose stays in the get, and how much stress or rest you get. normal range. RISKS TO THE MOTHER MAY INCLUDE: • Developing preeclampsia or high blood pressure which usually includes swelling BLOOD GLUCOSE (SUGAR) GOALS DURING PREGNANCY of the hands and feet. Time Target: Normal Blood Glucose Fasting & before meals Less than 95mg/dl • Having frequent kidney, bladder, or vaginal One hour from the start of meals* Less than 140 mg/dl infections. What Can I Do to Manage Gestational Diabetes? * For example, if you start to eat breakfast at 8 am, you would check your blood glucose (sugar) at 9 am. • Needing to deliver the baby early. The timing starts from the first bite of the meal. • Go to all of your doctor and diabetes center • Needing a C-section if the baby is too big to deliver through the birth canal. visits. Each pregnancy is different and your body changes as the weeks go by so many • Developing type 2 diabetes later in life. visits are needed. Quick Tips for Meal Planning • Test and record your blood sugar and food in RISKS TO THE BABY MAY INCLUDE: Our goal is to ensure you and your baby receive adequate nutrition. We want to make sure you are your diary eating healthy, well-balanced meals/snacks. • The baby growing bigger than he/she should. • This can happen if the blood glucose is high. Gain weight slowly • Breakfast matters most: blood glucose levels carbohydrates that are not processed. Good When your glucose levels are high, the extra • Exercise regularly often increase the most after breakfast. choices are whole grain bread, wild or brown glucose goes to the baby and the baby grows Avoid fruit, milk, juice, and cold boxed cereals rice, old fashioned oatmeal, beans, corn too rapidly and becomes too fat, which is not • Choose the right foods and portion size at breakfast. Eat 1 – 2 choices of carbohydrates tortilla, etc. healthy. A large baby can lead to a difficult and always include protein at breakfast. • For all meals or snacks it is suggested to have delivery that could cause injury to the baby. • Get enough sleep and control stress • Eat 3 meals and 2 – 3 snacks per day, a protein source (egg, cheese, cottage cheese, • • Sometimes a large baby can lead to an early Do daily kick counts and eat about every 3 hours. peanut butter, meats, etc), this will help keep you filling satisfied and keep your blood delivery but if a baby is delivered too early the Your healthcare team will be checking: • Allow no more than 10 hours from a nighttime baby’s lungs not fully developed. snack to breakfast the next day glucose level steady. • Your glucose meter — bring your meter to • Include two to three glasses of milk or • High blood sugar during pregnancy may • Avoid foods that spike the glucose the most: appointments yogurt in your meal plan. If you do not drink cause the baby’s blood sugar to get too low sweets such as candy, cookies, pastries, milk, there are other calcium food sources right after delivery. This is due to the baby no • Blood glucose numbers and food diary — desserts, honey, and syrup. (i.e. low fat or nonfat yogurt, cheese or cottage longer having the sugar being provided by the bring your diary to appointments • Avoid drinks that are high in sugar and cheese). If you are lactose intolerant there is mother. If a baby has low blood sugar the natural sugar such as fruit juice, regular soda, other food sources that have calcium, for doctor will need to start an IV to keep the • Weight gain Gatorade, Vitamin Water, lemonade, etc. example: beans, leafy greens, nuts, fortified glucose level steady. • The baby’s growth • Carbohydrates affect the blood glucose, but almond/soy milks. you still need to eat them. Carbohydrates The goal is to manage the blood glucose • Artificial sweeteners like aspartame provide both you and the baby with energy ® ® levels through diet and exercise. We will work (Nutrasweet /Equal ), acesulfame-K for growth. It is reasonable to have 2 – 3 ® ® closely with you to adjust your diet, exercise, or (SweetOne ) or sucralose (Splenda ) choices of carbohydrates for breakfast and medications as needed. With planning and may be used in limited quantities during 3 – 4 choices of carbohydrates food for lunch hard work on your part, both you and your baby pregnancy. Avoid use of saccharin. and dinner. Snacks should be 1 – 2 choices of will have a healthy, full-term pregnancy without carbohydrate food. See attached menu on • The dietitian will provide you with a complete complications. separate page for more examples. Choose meal plan during your appointment.