1. Presented by Erin Bostic

2. » Sessions with Registered Dietitians in order to discuss issues pertaining to gestational diabetes and what nutritional needs must be met in order for pregnancy to proceed in a positive manner

3. » Defined as glucose intolerance diagnosed during pregnancy » Effects 7-14% of women in U.S. (2011, Farrara) » Increases risk of type 2-diabetes after post- pregnancy » Diagnosed with 50 g glucose challenge test after 18 wks. And then 100 g oral glucose tolerance test

4. » Cardiovascular disease, c-section birth, shoulder dystocia, renal and retinal complications

5. To find whether intervention after GDM diagnosis is effective on the outcome of health status of mother during and after pregnancy

6. » 2 dietitians that are diabetes educators » One male: 26 years old with less field experience » One female: 38 years old with more field experience

7. » 55-item survey focusing on a dietitians knowledge of intervention for women with GDM » Questions created based on research done prior to interview » tape recorder used during interviews

8. Question Male RD AnswerFemale RD Answer Do women meet weight loss goal post pregnancy w/intervention? “Yes, they are more educated and self-reliant in my opinion” “Yes, I think it is because they have all the right tools to do so” Are recommended diets followed by women who attend intervention sessions? “I recommend low-glycemic foods and for the most part women tend to follow this advice” “Yes, I have my trouble cases but for the most part women do their best to follow the instructions I give them” Do many women stop attending sessions postpartum? “I would say about half of my paitents stop coming but it may partly be due to time constraints” “More of my patients stop attending after their baby is delivered” Do women seem to have a better understanding of condition after going through intervention sessions? “100%, Yes!” “Definitely” Do most women not exceed the recommended weight gain during pregnancy? “Most of my patients stay within my recommendations. I think this is because I stress the importance of the issue.” “For me it’s about half and half. Some women feel that since they are pregnant they can gain as much weight as they want. They do not realize the complications that come along with this choice.”

9. QuestionMale RD AnswerFemale RD Answer What is the best way a student could prepare themselves for their future profession? “I think volunteering at a hospital is a great way to become prepared and gives you a better understanding of what you are getting yourself into” “It is way different to be a student majoring in dietetics now than it was when I was in school, but it’s always a good idea to shadow a RD and of course get good grades” Is the job ever frustrating? “For me it’s usually more frustrating than not, because many patients are too stuck in their old ways” “It can be very frustrating, but it’s a great feeling when you finally get through to your patients about what needs to change” Why did you choose to focus your career around diabetes? “The topic always interested me as a student so I thought it was the route I should take” “In the beginning of my career I was working with CVD patients but I began to take an interest in diabetes and when the opportunity came to work with diabetics I took the job!”

10. » Intervention during and after pregnancy has a positive outcome on health status of mother in all aspects including weight loss, lower chance of type 2-diabetes, and other chronic diseases » Also decreases babies risk for LGA and type 2-diabetes when older

11. » Women may not attend intervention sessions for many different reasons including: Feel it is unnecessary Time constraints like work or taking care of baby Do not want to take time away from baby

12. » Attending intervention sessions with a Registered Dietitian will improve the overall health status of the mother » This includes weight loss postpartum, risk of type 2-diabetes, education on exercise, and weight gain during pregnancy » Also going to sessions postpartum is important to make sure mother is choosing a healthy lifestyle

13. » Much of the literature I referred to agreed with the research I conducted » Recommended intervention be required for women with GDM to improve their health outcomes during pregnancy and postpartum

14. » Would have rather had more than 2 subjects for the interview but was not able to find more » Initial plan was to interview women who had gestational diabetes but could not gather enough subjects

15. » Ferrara, A.; Henderson, M.M.; Albright C.L.; Ehlirich S.F.; Quesenberry JR., C.P.; Peng, T. A Pregnancy and Postpartum Intervention in Women With Gestational Diabetes Mellitus Reduces Diabetes Risk Factors. PubMed Central [serial online]. 2011. 34: 1519-1525. Available at: http://care.diabetesjournals.org/content/34/7/1519.full.pdf+html. Accessed October 12, 2012. http://care.diabetesjournals.org/content/34/7/1519.full.pdf+html