Gestational Diabetes Stress

[bunnyjadwiga]

Apologies for dumping this on your friendslist, but I want this quote out there:

"Clinicians must consider the impact on women's lives of stressors such as the diagnosis and treatment of gestational diabetes mellitus. The addition of careful diet planning, blood glucose monitoring, as many as three to four injections of insulin per day, additional visits to the health care provider, and increased fetal assessment may overburden some women who already experiencing stress. In developing a mutually agreed upon plan of care with women with gestational diabetes mellitus, clinicians must assess other stressors in the women's lives, their support systems, and their other responsibilities. Women must be offered understanding, professional support in their attempts to adhere to the treatment plan."

[Emphasis mine]
Cynthia Armstrong Persily, RN, Phd. "Relationships between the Percieved Impact of Gestational Diabetes Mellitus and Treatment Adherence." Journal of Obstetric, Gynecologic and Neonatal Nursing, Sept. 1996, 25:7 (601-607) p. 606.

Comments

[alphaggek.livejournal.com]

AMEN! And you never really got a "agreed upon plan of care" did you hon? Your doc at the time shoved it down your throat, didn't he?

[bunnyjadwiga.livejournal.com]

I don't think any of the docs or nursing staff really thought about 'agreement'-- it was "we are going to do this now" and if they felt like it, they would tell me why, but I really had to fight hard to get any discussion about why we should do something in particular.

[alphaggek.livejournal.com]

And I think that's wrong is so many ways. You've done your own research. You've reached (or will reach) your own conclusions, which might include stopping the insulin injections and all that crud. Decide how _YOU_ want to treat the pregnancy, walk into your Doc's office and tell them how it's going to be. You have the right to do that. The doc _CAN NOT_ force you to accept treatment. You're not in a life threatening situation, you are in full control of your mental faculties and you're not a danger to anybody. Take back control of your (and the fava bean's) medical treatment!

[anastasiav.livejournal.com]

Probably you don't have time to embroider this on a sampler (with bold and cites) and give it to them as a holiday gift, huh?

I'd absolutely print out the article and give it to them with highlights, however.

Its a proven fact that stress affects insulin levels in "regular" diabetics. Why wouldn't that hold true for GD as well.

Sheesh.

(A related point: Almost every woman I know with frustrating GD and/or "overcare" stories like yours lives in NJ or PA. I wonder if its a regional thing, maybe related to the way certain laws are written...?)

Regional laws

[bunnyjadwiga.livejournal.com]

I expect it's the malpractice laws and related malpractice insurance.

[hroar.livejournal.com]

Being a male diabetic, I agree wiht your emphasis. Sheesh! Idiots, who dont realize this!

[bunnyjadwiga.livejournal.com]

The person pushing the most interventionist gestational diabetes plans (Lois Jovanovic) is apparently a Type I diabetic. I suppose if you have tested and injected yourself all your life, advocating 8-9 tests and 4 sticks a day (as she does) during pregnancy doesn't seem too stressful for the patient.

[hroar.livejournal.com]

Oh good lord!
REALLY sheesh! I suppose one woudl get used ot it, BUT it takes time,,,and the perspective woudl be diffrant fo rsomeone who is GD.
Talk about stress!

[dr-zrfq.livejournal.com]

One would think that this would have been relatively easy to understand when that article was published... and that was *twelve years ago*... plenty of time for folks to put it into practice even if they hadn't figured it out before '96. Le heavy sigh.

**hugs**

another study

[bunnyjadwiga.livejournal.com]

A subsequent study, in 1989, found "No difference between [68] women with gestational diabetes and 50 non-diabetic pregnant controls, matched for gestational age, were found on the Profile of Mood States..." BUT the part that is hidden in that article is that a) they only looked at the Mood reponses in one interview, AND the women being studied had their blood glucose measurements taken ONLY weekly or, in the case of women on insulin, once daily. (I've written to one of the authors to be sure of this.) I'm wondering if the disruption to one's schedule caused by a 4x daily testing may be related to more stress, and whether the mood situation is influenced by when the mood profile is done in comparison to the date of diagnosis. (Also whether diagnosis at earlier gestational age is associated with poorer mood outcomes and higher stress.)

[amazon-42.livejournal.com]

Hon, can you find someone to do a maternity massage fo you? I'm serious. It might actually help your glucose levels.

BTW, this is why I was considered such a royal pain in the ass at my OB clinic. I refused to have anything shoved down my throat. Made up my own plans. Tested when I felt it was neccessary.

But then, not all of us have 3 pharmacists, a nurse, and 2 doctors in the family.

No matter what doctors say about preferring knowledgable patients, the fact is, most loathe them. Especially the REALLY educated patients, the ones who can not only call "bullshit" but cite their sources.

If nothing else? Have Jurgen give you a nice pedicure and massage.