1. Kelsi BaronCody Kryfka Hillary ColbryStephanie Logan Katelyn GaffneyMegan Moore

2.  People eat food which digest into glucose which then causes the pancreas to release insulin to lower blood sugar levels  In pregnancy, the placenta produces multiple hormones which impair the action of insulin in the mom causing the blood sugars to stay elevated.  90% of pregnant women develop GDM

3.  Between 24-28 weeks gestation a Oral Glucose Tolerance Test (OGTT) will be completed ◦ Woman drinks a syrupy glucose solution ◦ Wait 1 hour ◦ Gets blood drawn  Normal blood sugar level are <140  If >140, then a follow-up OGTT will be done ◦ Fast over night ◦ Drink a higher concentrated glucose solution ◦ Blood sugar levels are tested every hour for 3 hours  2 or more tests are higher than 140 then women is diagnosed with GDM

4.  Low blood sugars  Excessive birth weight  Type 2 diabetes later in life for mom & baby  Pre-term birth

5.  Family history of diabetes  During a pervious pregnancy  A baby weighing more than 9 pounds  Being overweight  Race

6.  Diet could limit or remove the need for medication interventions  Carbohydrates have the biggest impact on blood sugar levels  DO… ◦ Healthy portions ◦ Fruits, vegetables, whole grains ◦ Foods high in fiber, low in fat/calories  AVOID/LIMIT ◦ Sweets ◦ Refined Carbohydrates ◦ Eating Carbohydrates at breakfast/morning

7.  Necessary during and after pregnancy ◦ “Lowers blood sugar by stimulating your body to move glucose into your cells where it’s used for energy” (Mayo, 2014) ◦ Increases sensitivity to insulin ◦ Decreases possibility of later onset Type 2 diabetes  Moderate activity OR build up slowly ◦ Cycling, walking, swimming, housework, gardening

8.  If diet and exercise are not enough ◦ 10-20% of women with GDM need insulin  Oral and/or Insulin ◦ Common Oral Medication  Glyburide: stimulates pancreas-does not cross the placenta in significant amount  Metformin: decreases amount of glucose the liver makes-crosses placenta in small amounts ◦ Insulin  Requires more check ups with obstetrician-weekly or twice weekly  Non-stress test, ultrasound, kick counts, biophysical profile(combination non-stress test /ultrasound)

9.  Focus on maintaining normal blood glucose levels: Diet and Exercise  Insulin injection techniques if necessary  Monitoring anxiety and feelings of mother  Effective communication  Providing normal pregnancy care  Stress management  Postpartum care

10.  Reinforcement and review accurate information  Demonstration of specific skills  Teaching support persons skills and information on GDM  Knowledge of effects of GDM if poorly managed  Explain the need for frequent check-ups and tests

11.  Deficient Knowledge in management of gestational diabetes  Imbalanced nutrition less than body requirements

12.  After Birth  Complications  Risks ◦ Macrosomia ◦ Hypoglycemia

13.  Mayo Clinic. (2014). Gestational diabetes. Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases- conditions/gestational-diabetes/basics/definition/con- 20014854http://www.mayoclinic.org/diseases- conditions/gestational-diabetes/basics/definition/con- 20014854  Baby Center. (2014). The best kinds of exercise for pregnancy. Baby Center. Retrieved from http://www.babycenter.com/0_the-best-kinds-of-exercise- for-pregnancy_7880.bc http://www.babycenter.com/0_the-best-kinds-of-exercise- for-pregnancy_7880.bc