Insulin Resistance Research
http://home.comcast.net/~creationsunltd/overview.htm
Insulin Resistance
http://home.comcast.net/~creationsunltd/insulinresistance.htm
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http://home.comcast.net/~cnmpat
Healthy Lifestyle Choices
http://home.comcast.net/~cnmpat/siteindex.htm
About Pat and Walt Health Web Sites
About Midwives Pat's Site Map
Healthy Eating Favorite Sites Professional Book Reviews
Diabetes Web Sites WA State Midwives

Site Map: Masters Projects: CPGs and GDM
Diabetes Web Sites of Major Organizations
Gestational Diabetes Mellitus
GDM and Healthy Eating Handouts
GDM References
GDM Web Sites
Handouts and Teaching Aids for Health
My Passion for Healthy Eating
My Resume
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Gestational Diabetes Mellitus: 
Helping Your Client Make Healthy Food Choices
http://www.obgyn.net/displayppt.asp#perinatal [PowerPoint HTML]
GDM Handouts:
Guidelines for Healthy Eating
http://home.comcast.net/~creationsunltd/eathandout.htm
Making Healthy Food Choices
http://home.comcast.net/~creationsunltd/foodchoices.html
What is it?
http://home.comcast.net/~creationsunltd/aboutgdm.htm
GDM Web Links
http://home.comcast.net/~creationsunltd/gdmwebs.htnl
References
http://home.comcast.net/~creationsunltd/refcite.htm
American Diabetes Association 2002 Position Statement for GDM
http://care.diabetesjournals.org/cgi/content/full/25/suppl_1/s94
For obese women (BMI >30 kg/m2), a 30–33% calorie restriction (to ~25 kcal/kg actual weight per day) has been shown to reduce hyperglycemia and plasma triglycerides with no increase in ketonuria (2). Restriction of carbohydrates to 35–40% of calories has been shown to decrease maternal glucose levels and improve maternal and fetal outcomes (3).
nsulin is the pharmacologic therapy that has most consistently been shown to reduce fetal morbidities when added to MNT. Selection of pregnancies for insulin therapy can be based on measures of maternal glycemia with or with-out assessment of fetal growth characteristics. When maternal glucose levels are used, insulin therapy is recommended when MNT fails to maintain self-monitored glucose at the following levels: Fasting whole blood glucose <=95 mg/dl (5.3 mmol/l) Fasting plasma glucose <=105 mg/dl (5.8 mmol/l) or 1-h postprandial whole blood glucose <=140 mg/dl (7.8 mmol/l) 1-h postprandial plasma glucose <=155 mg/dl (8.6 mmol/l) or 2-h postprandial whole blood glucose <=120 mg/dl (6.7 mmol/l) 2-h postprandial plasma glucose <=130 mg/dl (7.2 mmol/l)
Major CA, Henry MJ, De Veciana M, Morgan MA: The effects of carbohydrate restriction in patients with diet-controlled gestational diabetes. Obstet Gynecol 91:600–604, 1999.
Handouts and Teaching Aids for Health
Achieve Your Healthy Weight: NHLBI Obesity Education Initiative
http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/index.htm
Body Mass Index: How to Determine: The American Obesity Association
http://nutrition.ucdavis.edu/www/bmi.htm
Body Mass Index: What it Means: American Heart Association
http://www.americanheart.org/Heart_and_Stroke_A_Z_Guide/body.html
American Heart Association: http://www.americanheart.org/
Dietary Guidelines for Healthy American Adults: A Statement for Health Professionals From the Nutrition Committee, American Heart Association 
http://www.americanheart.org/Scientific/statements/1996/1001.htm
Cholesterol Levels (AHA)
http://www.americanheart.org/Heart_and_Stroke_A_Z_Guide/chollev.html
Triglycerides (AHA)
http://www.americanheart.org/Heart_and_Stroke_A_Z_Guide/trigly.html
Glycemic Index Master Chart: http://www.mendosa.com/gilists.htm
Low Carb Food Pyramid: http://www.enteract.com/~jldavid/lowcarb/pyramid.html
Meridia Consumer Information: http://www.4meridia.com/consumer/3700.html
Nutrition Recommendations and Principles for People With Diabetes Mellitus
American Diabetes Association: Clinical Practice Guidelines
http://care.diabetesjournals.org/content/vol25/suppl_1/
POLYCYSTIC OVARY SYNDROME (PCOS):
Obgyn.net PCOS Pavilion: http://www.obgyn.net/pcos/pcos.htm
http://www.obgyn.net/pcos/articles/copperman_pcosfaq.htm
What is PCOS?:http://www.obgyn.net/pcos/articles/whatispcos.htm
Health Links Resources:
What is Insulin Resistance
http://syndromex.stanford.edu/InsulinResistance.htm

GD Web Sites: Health Care Sites for Consumers
MyPassion for Healthy Eating
My lifelong struggle with weight issues, diets and staying healthy has brought me finally to a place of self acceptance.   I decided to write about this topic for three reasons. One was to provide  this information  to other clinicians as a reference point to improve their understanding the concepts of Insulin Resistance and the Glycemic Index, and begin to incorporate this information into their practice. 
The second reason was to thoroughly research the topic and prove to myself that this is a viable alternative to what is currently being promoted in the USA. I have been using the Glycemic Index for over 3 years now, and have become aware of the affects of high GI foods and sugar on my body, and how different I feel when I eat low GI foods and adequate protein along with healthy fats.  I do not have truncal obesity, but I am at increased risk for diabetes, with a BMI of 30 and having a child who weighed >9 # at birth.  
The third reason is to prevent the development of diabetes and syndrome X in myself, and diet seems like a logical way to do this. I want to understand and prevent diabetes, and the other short term and long term consequences. If teen who are developing Insulin Resistance and PCOS can be helped to not face being obese, my heart will be warmed.  
The Power Point presentation narrows the topic down to something that is relevant to all midwives: Gestational Diabetes. What has been learned about Insulin Resistance can be applied to Gestational Diabetes Mellitus.  I've developed some handouts that you may use for your clients, and adapt them as you wish.  I wish to thank Trish Reynolds, CNM, who helped me with this project.  
I am currently studying Nutrition in depth and will become a Professional Nutrition Specialist. I currently provide nutritional counseling for individuals who seek my services. My special interests include Healthy Lifestyle Choices, Insulin Resistance, PCOS and Diabetes Prevention
My career  as a nurse practitioner and nurse midwife has shown me the value of prevention, and this is about prevention. This paper has been written for Critical Inquiry I and II through Philadelphia University, Master of Science with a focus in Midwifery. The Institute of Midwifery and Women's Health http://www.philacol.edu/graduate/midwifery.html
Updated: 07/19/2003 Pat Sonnenstuhl, ARNP, CNM   cnmpat@comcast.net