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RE: [IPk] blood glucose levels in early pregnancy



I was under the impression that gestational diabetes was more closely linked to
type 2 diabetes rather than type 1.  So if one developed gestational diabetes
 during pregnancy it meant that you were more likely to develop type 2
especially
if ones parents had type 2.

I would be interested to know what the second opinion is?  


Perhaps this article below might be of interest just posted on the UK CWD
mailing list

http://bmjopen.bmj.com/content/3/11/e003583.full


What happens when patients know more than their doctors?

Experiences of health interactions after diabetes patient education: a
qualitative patient-led study


Abstract
 Objective To explore the impact of patient education on the lives of people
with
 diabetes, including the effect on interactions with doctors and other
healthcare
professionals.
Design Qualitative user-led study using longitudinal interviews and 146 h of
participant observation. Data were analysed using a narrative approach.
Participants 21 patients with type 1 diabetes, those either about to attend a
patient education course or those who had completed the course in the previous
10 years.
Setting Established patient education centres in three UK teaching hospitals
teaching the Dose Adjustment for Normal Eating (DAFNE) course.
Results Both postcourse and several years later, most participants spoke of the
experience of taking part in education as life-changingly positive. It helped
them understand how to gain control over a very complex disease and freed them
 from dependence on medical advice and restrictive regimes. However,
interactions
within the health system following patient education could be fraught.
Participants emerged from the course with greater condition-specific knowledge
than many of the healthcare professionals they encountered. When these
professionals did not understand what their patients were trying to do and were
uncomfortable trusting their expertise, there could be serious consequences for
these patients' ability to continue effective self-management.
Conclusions Patients who have in-depth knowledge of their condition encounter
problems when their expertise is seen as inappropriate in standard healthcare
interactions, and expertise taught to patients in one branch of medicine can be
considered non-compliant by those who are not specialists in that field.
Although patient education can give people confidence in their own
self-management skills, it cannot solve the power imbalance that remains when a
generalist healthcare professional, however well meaning, blocks access to
 medication and supplies needed to manage chronic diseases successfully. There
is
a role for those involved in primary and hospital care, including those
supporting and training healthcare professionals, to recognise these problems
and find ways to acknowledge and respect chronic patients' biomedical and
practical expertise.





"The person with diabetes who knows the most lives the longest." Elliot Joslin

http://www.childrenwithdiabetesuk.org/


Jackie Jacombs, mum of Sasha aged 19, diagnosed with diabetes in 1999 at
the age of 4 years.  Using Paradigm Veo pump. Sasha has an identical
twin sister Rebecca, both twins have coeliac, I have two older girls,
Nicki and Danni,  husband Terry





-----Original Message-----
From: email @ redacted [mailto:email @ redacted] On Behalf Of
Nanette Freedman
Sent: 13 December 2013 09:34
To: ip-uk
Subject: [IPk] blood glucose levels in early pregnancy

 A question on behalf of my daughter - she is not diabetic, but has had what
seem
to me very marginally raised fasting blood glucose levels (typically around 5 -
5.5) for a while. She is now in the early weeks of pregnancy, and her high-risk
pregnancy specialist is telling her that he is concerned and that for sure she
will go on to develop gestational diabetes (which she thinks unlikely since was
carefully tested - because of family history - and did not in her 2 previous
 pregnancies). He wants her to start taking insulin. She is in any case seeking
a
 second opinion, but I wondered if anyone on this list has relevant experience
or
information to offer. I know that most of the people on this list who have gone
through pregnancy were in a different situation having had type 1 before they
 were pregnant, but what do you think? also are levels around 5 - 5.5 first
thing
in the morning a real cause for concern - given that her post-prandial levels
are just fine.
Many thanks for any advice
Nanette (snowed in in Jerusalem - very beautiful, but quite problematic!) .
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