Blog Archive
- ► 2023 (8)
- ► 2022 (88)
- ► 2021 (54)
Blog Archive
- ► 2023 (8)
- ► 2022 (88)
- ► 2021 (54)
Gestational Diabetes
September 2014
With the rapidly rising rates of gestational diabetes mellitus (GDM) seen today, it’s worthwhile reviewing the research. The paper that I’d like you to read and print out for your colleagues clearly shows how chronic diabetes mellitus develops frequently and very quickly when a mother does not breastfeed following a GDM-affected pregnancy. The full text of this journal article is freely available online.
The article, published in the journal Diabetes, studied women who had GDM with the outcome measure being the development of diabetes mellitus after delivery. The follow-up period was extensive, up to 19 years (and still continuing). The variables studied included islet cell antibody status (positive or negative), diabetes treatment during pregnancy (diet or insulin), BMI (obese or not obese) and lactation (no breastfeeding, breastfeeding ≤3 months, breastfeeding >3 months, no full breastfeeding).
The small number of mothers who were islet cell antibody positive all developed diabetes mellitus within 6 months of delivering.
For the remaining mothers, not breastfeeding or weaning within the first 3 months had an enormous impact on their development of diabetes mellitus. The study demonstrated upwards of 18 diabetes-free years in the women who breastfed compared to an average of 2 years in formula-feeding women 3(Ziegler et al, 2013). Pause a moment and consider how this fact impacts on the personal and national levels.
Unfortunately, compared to the national average, fewer women who have GDM even initiate breastfeeding. Additionally mothers can experience delayed onset of lactation 1 (Matias SL, 2014) and newborns of mothers with GDM are more frequently admitted to NICU 2(Cordero L, 2013). Quality prenatal education and proactive evidence-based newborn and maternal care will make a difference to these poor statistics.
Questions to think about
- When a woman is diagnosed with gestational diabetes in your Unit what discussion occurs with the mother and her support people?
- Are they explicitly told of the effect their feeding choice will have on the mother’s and infant’s health?
- Is this discussion led by knowledgeable staff who can appropriately support and encourage initiation of breastfeeding?
- With both mother and baby having risk factors for breastfeeding failure what strategies are in place to ensure they receive additional support, encouragement and ideal breastfeeding management postnatally?
Have a great month,
Denise
1. Matias SL, Dewey KG, Quesenberry CP Jr, Gunderson EP. (2014) Maternal prepregnancy obesity and insulin treatment during pregnancy are independently associated with delayed lactogenesis in women with recent gestational diabetes mellitus. Am J Clin Nutr. 99(1):115-21. doi: 10.3945/ajcn.113.073049. Epub 2013 Nov 6.
2. Cordero L, Gabbe SG, Landon MB, Nankervis CA. (2013) Breastfeeding initiation in women with gestational diabetes mellitus. J Neonatal Perinatal Med. 6(4):303-10. doi: 10.3233/NPM-1372513.
3. Ziegler AG, Wallner M, Kaiser I, Rossbauer M, Harsunen MH, Lachmann L, Maier J, Winkler C, Hummel S. (2012) Long-term protective effect of lactation on the development of type 2 diabetes in women with recent gestational diabetes mellitus. Diabetes. 61(12):3167-71. doi: 10.2337/db12-0393. Epub 2012 Oct 15. http://diabetes.diabetesjournals.org/content/61/12/3167.long
Step 2 Education International Inc.
Montreal, Quebec, Canada
H4A 1G2
Courriel
This Privacy Policy describes how your personal information is collected, used, and shared when you visit or make a purchase from https://step2education.com (the "Site").
PERSONAL INFORMATION WE COLLECT
When you visit the Site, we automatically collect certain information about your device, including information about your web browser, IP address, time zone, and some of the cookies that are installed on your device. Additionally, as you browse the Site, we collect information about the individual web pages or products that you view, what websites or search terms referred you to the Site, and information about how you interact with the Site. We refer to this automatically-collected information as Device Information."
We collect Device Information using the following technologies:
- "Cookies" are data files that are placed on your device or computer and often include an anonymous unique identifier. For more information about cookies, and how to disable cookies, visit http://www.allaboutcookies.org.
- "Log files" track actions occurring on the Site, and collect data including your IP address, browser type, Internet service provider, referring/exit pages, and date/time stamps.
- "Web beacons," "tags," and "pixels" are electronic files used to record information about how you browse the Site.
Additionally when you make a purchase or attempt to make a purchase through the Site, we collect certain information from you, including your name, billing address, shipping address, payment information (including credit card numbers), email address, and phone number. We refer to this information as "Order Information."
- Users who are undertaking a course as part of a group or organization have certain data tracked as part of the service we provide to Clients and Facilitators. This includes information showing if you have logged in and when, dates of completion and what and when particular study topics, resources and assessments were viewed and completed. We refer to this information as "Student Access Information"
When we talk about "Personal Information" in this Privacy Policy, we are talking about Device Information, Order Information and Student Access Information.
HOW DO WE USE YOUR PERSONAL INFORMATION?
We use the Order Information that we collect generally to fulfill any orders placed through the Site (including processing your payment information, arranging for shipping, and providing you with invoices and/or order confirmations). Additionally, we use this Order Information to:
- Communicate with you;
- Screen our orders for potential risk or fraud; and
- When in line with the preferences you have shared with us, provide you with information or advertising relating to our products or services.
We use Student Access Information to provide accurate tracking to Users and Clients on completion and use of the courses, as well as for analysis on how to improve our services.
We use the Device Information that we collect to help us screen for potential risk and fraud (in particular, your IP address), and more generally to improve and optimize our Site (for example, by generating analytics about how our customers browse and interact with the Site, and to assess the success of our marketing and advertising campaigns).
SHARING YOUR PERSONAL INFORMATION
We share your Personal Information with third parties to help us use your Personal Information, as described above. For example, with your employer who needs to verify your completion or progress of your studies. We also use Google Analytics to help us understand how our customers use the Site--you can read more about how Google uses your Personal Information here: https://www.google.com/intl/en/policies/privacy/. You can also opt-out of Google Analytics here: https://tools.google.com/dlpage/gaoptout.
Finally, we may also share your Personal Information to comply with applicable laws and regulations, to respond to a subpoena, search warrant or other lawful request for information we receive, or to otherwise protect our rights.
BEHAVIOURAL ADVERTISING
As described above, we use your Personal Information to provide you with targeted advertisements or marketing communications we believe may be of interest to you. For more information about how targeted advertising works, you can visit the Network Advertising Initiative's ("NAI") educational page at https://www.networkadvertising.org/understanding-online-advertising/how-does-it-work.
You can opt out of targeted advertising by:
- Facebook: https://www.facebook.com/settings/?tab=ads
- Google: https://www.google.com/settings/ads/anonymous
Additionally, you can opt out of some of these services by visiting the Digital Advertising Alliance's opt-out portal at: http://optout.aboutads.info.
DO NOT TRACK
Please note that we do not alter our Site's data collection and use practices when we see a Do Not Track signal from your browser.
YOUR RIGHTS
If you are a European resident, you have the right to access personal information we hold about you and to ask that your personal information be corrected, updated, or deleted. If you would like to exercise this right, please contact us through the contact information below.
Additionally, if you are a European resident we note that we are processing your information in order to fulfill contracts we might have with you (for example if you make an order through the Site), or otherwise to pursue our legitimate business interests listed above. Additionally, please note that your information will be transferred outside of Europe, including to Canada and the United States.
DATA RETENTION
When you place an order through the Site, we will maintain your Order Information and Student Access Information for our records unless and until you ask us to delete this information. We are required to keep course completion records for at least 5 years in order to comply with certain accreditation requirements.
CHANGES
We may update this privacy policy from time to time in order to reflect, for example, changes to our practices or for other operational, legal or regulatory reasons.
CONTACT US
For more information about our privacy practices, if you have questions, or if you would like to make a complaint, please contact us by e-mail at [email protected] or by mail using the details provided below:
5890 Monkland Avenue, #16, Montreal, QC, H4A 1G2, Canada
Last Updated: September 2018