When diabetes starts during pregnancy, it is called gestational diabetes. Women with diabetes (whether or not it is classified as gestational diabetes) need special care during pregnancy.
Diabetes is a condition that prevents the body from using food properly. The body receives its major source of energy from a sugar known as glucose. Insulin, a hormone manufactured in the pancreas, must be available for glucose to be used in the tissues. During pregnancy, some of the hormones produced by the placenta have a blocking effect on insulin. Gestational diabetes occurs when the pancreas produces its maximum amount of insulin, yet that is not enough to overcome the effect of the placenta’s hormones.
What are the risk factors for gestational diabetes?
Gestational diabetes is more common in women who
- are overweight or obese
- are older than 25
- have had gestational diabetes in a prior pregnancy
- are African American, American Indian, Asian American, Hispanic, Latina or Pacific Islander
- have a family history of diabetes
- have previously given birth to an infant that weighed more than 10 pounds
- had excess amniotic fluid in a prior pregnancy
- had an unexplained stillbirth or miscarriage in a prior pregnancy
How is gestational diabetes diagnosed?
At Virginia Women’s Center, we screen for gestational diabetes at 28 weeks of pregnancy. You will have to drink a syrupy glucose solution and then have your blood sugar level measured one hour later. If your blood sugar level is higher than normal, you will have to do a follow-up glucose test. The follow-up test involves drinking another glucose solution and having your blood sugar level checked every hour for a three hour period. If at least two of the blood sugar readings are higher than normal, you will be diagnosed with gestational diabetes.
What if I am diagnosed with gestational diabetes?
If you are diagnosed with gestational diabetes, you will work closely with our nurse practitioners to create an individualized food plan. You will not have to give up foods you love, but you may have to limit them or eat them with other foods so that your blood sugar isn’t negatively affected. During pregnancy, you will have to manage your blood sugar so that it stays in the optimal range and reduces your risk for complications. Usually, this can be done through diet and exercise. You will also work closely with our physicians and may need additional testing to monitor the baby’s health and reduce the risk of complications throughout your pregnancy.
For most women, once the baby is delivered, gestational diabetes will go away. You will be tested again at your postpartum visit. If it does not go away, it is reclassified almost always as type II diabetes. Women who had gestational diabetes are at high risk of having diabetes later in life. Choosing to pursue a healthy lifestyle by eating nutritiously and exercising regularly may help prevent or postpone diabetes.
Additional Resources:
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In addition to regular screening mammograms and clinical breast exams, some women choose to perform a formal step-by-step breast self-exam and others prefer a visual inspection. No matter the technique you choose (both can be performed in the comfort of your own home and without any formal training), it’s important that you are aware of what your breasts normally look and feel like. Should you notice any changes, you can proactively seek medical care.
When inspecting your breasts, stand or sit in front of a mirror. Pay attention for the following changes:
- Changes in color or shape of your breast
- Changes in color or texture of your skin
- Changes in nipple shape or texture
- Evidence of nipple discharge
- Dimpling or puckering anywhere on your chest
Learn more: http://www.
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By Guest Author: Susan Uhle, NP - Richmond Surgical
Early detection is currently the cornerstone of our arsenal in the war against Breast Cancer. This is accomplished through Mammographic Screening, and, at times, other imaging methods such as Ultrasound and Breast MRI. Findings from Mammography can lead to Needle Biopsy, where results can range from benign, to benign but abnormal, to cancer. These results dictate the next action, which may include surgery or closer surveillance. The results also allow us to better stratify individual risk.
As an example, Christina undergoes Screening Mammogram, leading to a Needle Biopsy; results show Atypical Ductal Hyperplasia (ADH). Her risk of developing cancer is now known to be four times that of a woman her age without those findings. There are certain measures she can take to decrease that risk, including lifestyle modification, surveillance, and chemo prevention.
On the other hand, there are individuals with a personal or family history, who should be further evaluated at the time of Mammography or during the office visit. We know that a family history in a first degree relative (mother, sister, or daughter) confers an increased risk.
If we look further and the Breast Cancer was one of several types (early onset, two separate Breast Cancers, Male Breast Cancer, Ovarian Cancer, Multi-Generational), we would consider whether there is an inherited mutation in the family. Although this is present in only 5 to 10% of individuals, the Breast and Ovarian Cancer risk is as high as 87% and 44% lifetime. Preventive Mastectomy and removal of ovaries is the choice of many, but not all, women. This reduces the risk of Breast and Ovarian Cancer, but not to zero.
This is prevention; one form of risk management, as was chosen by Angelina Jolie. This is a personal decision, to be made with all facts in place and with information from a health care provider with extensive knowledge in this area. For those at a lesser risk, at the opposite end of the continuum, one would start with lifestyle changes and medication.
For further questions, or to schedule a consultation, please contact Richmond Surgical at 804.285.9416.
]]>As we plan to spend more time in the sun during the summer months, it is important to prevent skin cancer by protecting ourselves from the harmful rays of the sun.
Melanoma is one type of skin cancer that begins in melanocytes, cells that make the pigment melanin. It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines.
“ABCDE” can help you remember what to look for in existing or new moles:
- Asymmetry: The shape of one half does not match the other half.
- Border that is irregular: The edges are often ragged, notched or blurred in outline. The pigment may spread into the surrounding skin.
- Color that is uneven: Shades of black, brown and tan may be present. Areas of white, gray, red, pink or blue may also be seen.
- Diameter: There is a change in size, usually an increase. Melanomas can be tiny, but most are larger than the size of a pea (larger than 6 millimeters or about 1/4 inch).
- Evolving: The mole has changed over the past few weeks or months.
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Infertility can be caused both by female factors and male factors. There are many causes of infertility, but there are also times when the cause cannot be determined. Some of the causes for female infertility include:
- Being overweight, underweight or having an eating disorder
- Intense exercise
- Age – the possibility of infertility increases with age
- Stress or depression
- Hormonal imbalance
- Brief or irregular menstrual cycles
- Substance abuse – smoking, heavy drinking, drug use
- Tumor or cyst
- Thyroid problems
- Damaged reproductive organs
- Sexually Transmitted Diseases (STDs)
- Tubal disease
- Endometriosis
If you are trying to conceive, you may consider having an evaluation for infertility if you experience the following:
- If you are under 35 and have not become pregnant after one year of having regular sexual intercourse without birth control
- If you are over 35 and have not become pregnant after six months of having regular sexual intercourse without birth control
- If your periods are not regular
- If you or your partner has a known fertility problem
Your OB-GYN can conduct a basic fertility evaluation. Depending on what is found, he or she may refer you to a physician who specializes in fertility – a reproductive endocrinologist. A physical examination can help determine what is preventing conception. There are a wide range of options available to assist couples in achieving a successful pregnancy. They include lifestyle changes, behavioral modifications, drug treatments and surgeries.
Additional Resources:
- American Fertility Association
- RESOLVE: The National Infertility Association
- American Society for Reproductive Medicine
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April 29: Genetic Counseling
Genetic counselors work with mothers and couples to explain the array of prenatal testing options available as well as help interpret test results. At Virginia Women’s Center, our genetic counselor works closely with our maternal- fetal medicine specialists and obstetricians.
April 15: Urology – Incontinence
April 1: Obstetrics – Planning pregnancy
Richmondmom.com is so excited to announce to our readers that Virginia Women’s Center is now providing a Weekly Health Tip on our website! This is a great way for women to continually find new ways to take better care of themselves. The tip is easily accessible with our link on the right-hand side of our website’s front page. Simply click the link to find a current week’s tip or to access tips from previous weeks.
Suggest a Topic
You can submit a topic you’d like to learn more about. It may be included in future weekly tips or articles on our site.
Simply submit your topic idea to kate@richmondmom.com and we’ll forward it on to our Virginia Women’s Center professionals for review.
Thanks to Virginia Women’s Center for this valuable resource for local Richmond women!
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Click here to learn more about women’s health and taking care of yourself.
Each week beginning in April 2013, Virginia Women’s Center will provide us with a Weekly Healthy Tip – making it easier to stay healthy!
Women’s Health Tips
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