GynoFiles

More normal weight women are being diagnosed with Type 2 Diabetes in spite of being normal weight and not seeming to have the traditional risk factors for diabetes. In an article about this condition in the Mayo Clinic Proceeding s they looked at the factors that cause the condition they now call the 'metabolically obese normal weight' individual and found that diet was the most important reason individuals find themselves in this condition. The key points in the article were that it is possible to be obese, and have too much body fact and be normal weight,  we have to use alternative definitions for metabolic obesity to identify these patients and help them resolve their condition, because they are at risk for cardiovascular disease. One of the most important points in the article was that abdominal obesity was a more important indicator of risk than overall weight. The two diet strategies they found most helpful were DASH (a heart healthy anti-hypertensive diet), and the ...

Un-diagnosed diabetes can cause disease that is preventable. the American Diabetes Association in 2016 new standards has recommended that all adults age 45 and over, and all overweight or obese adults should be screened for diabetes. Diabetics have poor sugar control, and the reason is ultimately due to the function of insulin. Sugar intake is highly related to this, so that over time those who are obese or taking in too much sugar are most likely to also develop poor function of insulin. Although all experts agree that there are some genetic causes and some dietary causes and some cases of diabetes due to cell aging in our pancreas there is a new condition: LADA that not many talk about. LADA stands for latent autoimmune diabetes of adults. The levels of insulin precursor molecules rises and the level of glutamic acid decarboxylase auto-antibodies rise as well.. This condition is just being studied and we think that the degree of poor sugar control will have the same consequences of ...

The benefits of breastfeeding for baby has never been in doubt. The health benefits of breastfeeding for mom were mostly for many years focused on faster post partum weight loss, and then the focus blurred with not only on benefits, but physical negatives for mom from breastfeeding. The saying 'you loose a tooth for each child' meaning the loss of bone calcium in pregnancy exaggerated by calcium loss during breastfeeding. Nutrition, exercise, and avoiding smoking has pretty much eliminated that concern! But interestingly as we have begun to scientifically explore the wide ranging benefits for mom from breastfeeding beyond weight loss: less diabetes, less breast cancer, less hypertension, fewer myocardial infarctions, and now it has been shown to help prevent cardiovascular disease due to less atherosclerosis, in a study on lactation from the CARDIA group.  Breastfeeding to reduce the physical risks of gestational diabetes is becoming more and more important as gestational di...

We just can't get to sleep, and the scientific statistics prove it. This is not good news as those with poor sleep have much poorer health and a shorter life span as well. To try to over come this we take sleeping pills! At any given time millions of adults in the United States — or 8.6 million — report taking prescription sleeping aids, according to a new report released by the Centers for Disease Control and Prevention (CDC). The rates are creeping towards 10% of those 80 and above taking sleep medicine, and it's mostly the women who are taking them. As a gyno I do not want the patients taking medication unless they need to, but what is more disturbing is that over 50% of adults report poor sleep, so we need to think about the things we can do to improve sleep. There is another culprit which is robbing us of sleep and that would be shift work. Those with shift that rotate or those that take night shifts have a lot worse sleep. Maybe its just living a in city that is the ...

At Women’s Health Practice we advocate a pregnancy planning visit, at which time women are screened for abnormal sugar tolerance as well as diabetes. Then if you conceive, the question is when to repeat the testing for diabetes. ACOG (American College of Obstetricians and Gynecologists) and the ADA (American Diabetes Association) have been the two organizations weighing in on the standards that are used. The standard plan after a woman is pregnant to then test women at risk early in pregnancy, and then all women at their 28 week visit. A new guideline says doing testing mostly at 28 weeks misses as many as three quarters of all the gestational diabetes. A new guideline suggests that all pregnant women should be tested for diabetes at their first prenatal visit, unless they have already been diagnosed with the condition, according to a new clinicalpractice guideline from the Endocrine Society. Women who test abnormal on screening tests have been asked to to do further testing, l...

If you had diabetes when pregnant, you likely got to stop your medications and intense regimen of blood sugar checking almost as soon as your baby was born. And if you keep up your diabetic diet, exercise, and especially if you breastfed you were likely to not to be diabetic in  those early days. But only testing can determine if you have a normal blood sugar or not. The current recommendation is to get tested at the time of your post partum visit, and your physician may recommend a 2 hour sugar tolerance test (GTT). This more rigid testing is finding that about one in three women who are tested right at that 6 week check up will still have diabetes. And current studies are showing about half of all those who had diabetes in pregnancy will become diabetic in later life. Some gynos will not test until about 3 months out, and most will recommend testing again as your baby turns 3, to see if you are a diabetic. There are a number of ways to test once you have had a baby, but having...

Could their perhaps be a way to avoid the irregular periods, the weight gain, the unwanted hair growth, or the acne of PCOS that is actually nutritionally based? Oral contraceptives, anti-androgen medications and hypoglycemic agents are mostly what is given. But careful study shows that some women with polycystic ovarian syndrome could benefit by nutritional management as well. Inositol is a vitamin in the B group that has never been considered an essential vitamin as our bodies do make this from sugar (glucose). It is also in many of the foods we eat fairly regularly such as oranges and cantaloupes. But physicians and nutritionists have begun to look at this compound as a treatment for polycystic ovaries and diabetes and some birth defect prevention such as neural tube defects. A group of Italian physicians recently looked at whether this could reduce the risk of getting gestational diabetes if you supplemented the moms with 4 grams of myo-inositol daily, and it may have worked to ...

Over 60 million Americans today are Prediabetic. For those with Prediabetes, they are very high risk to become diabetic over the next ten years. In fact they have a 49% greater chance of having a heart attack than if they didn't have diabetes. Getting diagnosed with diabetes is also critical step in prevention of blindness, heart disease, kidney disease and peripheral vascular disease. More American women need blood sugar testing, and even if you have been tested in the past, don't rely on those tests forever. According to the newest guidelines 29 million people nationwide have then progressed to diabetes, yet  an estimated 8.1 million don’t know they have the condition, based on the U.S. Centers for Disease Control and Prevention . American Diabetes Association sets the definition of diabetes , yet other organizations such as ACOG and the endocrine society do weigh in on how we define diabetes. And for pregnant moms, we tightened down the rules once again. Diabetes in preg...

Gestational diabetes is becoming more and more common. Almost 7% of the population will be diagnosed with diabetes, and almost all are women who become diabetic in the pregnancy known as gestational diabetes.Current blood sugar numbers in pregnancy used to diagnose diabetes are so strict that almost half of those women diagnosed will not have any risk factors. So if you are pregnant you will be tested and if you do not pass the test you will have to follow dietary restrictions aimed at keeping your blood sugar both stable and in the normal range while still eating enough calories and gaining a proper amount of weight. Although how good your diet has to be in your pregnancy to have the most chance of a healthy baby is still being debated; we do know that women who have a diagnosis of diabetes in pregnancy will be more at risk for diabetes later in life.  Breast feeding can reduce the chance that a woman will have impaired glucose metabolism in the post partum period of time. A st...

We have gabbed several times about our life as a fetus and the the effects of the 9 months of intrauterine environment on our ultimate development and health. There are all the expected ways: blood flow across the placenta allows us to grow and thrive to our full genetic size, sugar levels as sent to us across the placenta affecting whether we are born a diabetic, medications  and vitamins can cross making us susceptible to withdrawal or deficiency symptoms, infections and immune antibody protection factors (this is why if you have had Herpes before the baby cannot catch it from you while just growing the the uterus) to just name a few. But there are many unexpected effects of the intrauterine environment on our eventual health and well being, and we’ve talked about those in a few posts as well. The newest guidelines regarding blood pressure and diabetes can be found in the NICE website . One of the newest is a piece of research designed to explain the still inexplicable ...

Test for the next 20 years if you have become a diabetic in pregnancy because you have about a 50% chance of becoming a diabetic in that time. At the turn of the last century a young Massachusetts researcher Dr. Elliot Joslin began to do pioneering work in diabetes. A few years later an energetic young women named Priscilla White joined his practice and was assigned worked with the children who had diabetes, it became clear to her the links with the family and the mom, and soon she was off and inventing what is basically still used today (in a modified form) known as the White classification of gestational, or diabetes in, pregnancy. And she quickly realized that it was the half of diabetics that have significant blood abnormalities that have the worse outcomes. The fifty fifty facts of what happens to those babies is that even in early pg there is about 25% risk of malformations if the sugar is out of control and there is about a 25% risk of miscarriage for the same reason. So in f...