I was not going to see the doctor for another week, so I didn't know if that counted as "pass". Searching for more advice from PTT and looking at the posts of expectant mothers who were diagnosed with gestational diabetes, I went ahead and purchased a blood glucose meter. And so I continued my journey of poking fingers an hour after my meals to see how I fare on the glucose meter. Once you have established a "safe meal" that does not spike your glucose, you can save yourself from poking your finger afterwards.
After almost two weeks of further self monitoring, I have found a few "safe meal" combinations that seem to work for me. Here are some of the snack options, usually eaten 2-3 hours after lunch and right before I sleep. The scale I have at home is somewhat inaccurate, so even though it seems to indicate I have no gained weight since my last prenatal visit two weeks, I won't know for sure until I go for my next visit on Tuesday. But now that I think about it, I'll probably head to the pharmacy later to get ketone test strips. It has been used to screen for diabetes mell-itus, to diagnose diabetes and to monitor glucose control.
During acute illness or stress or when blood glucose levels are consistently elevated (e.g. Glucose and Ketone Testing In One MeterThe same Nova meter used for hospital glucose testing also tests for ketones. Glucose and Ketone Testing From Capillary SamplesCapillary samples are not only preferred over urine samples to detect DKA,they are also easier to obtain and allow for immediate reflex testing of ketones.
StatStrip Blood Ketone Results in Only 10 Seconds StatStrip blood ketone results will quickly detect ketotic states for fast treatment decisions in DKA emergencies. Multi-WellTM Technology Measures and Eliminates Interferences StatStrip Multi-Well technology measures and eliminates inferences such as hematocrit, asorbic acid, acetaminophen and uric acid.
From the PTT BabyMother board, I knew that people would sometimes skip breakfast before they go for the screening so they have a better chance of passing. Whether my self-reporting had anything to do with the doctor's decision, I don't know, but she ordered me to do the 3-hour glucose tolerance test.
Like every other PTT expectant mother who failed the first or even the second test, I felt like I failed at being a person. I was told to not eat after 7PM the day before, show up at 8:30AM the next day, and expect to not have anything besides the disgusting 100 grams of glucose until noon.
I was a little put off when I ran out of the 30 gauge needles that came with the meter and had to switch to the 33 gauge (more fine) needles.
For the expectant mothers diagnosed with gestational diabetes and were forced to have counseling with nutritionists, what did they eat? My questions and uncertainities got cleared by the straight forward and well organised information. Microalbuminuria and urinary ACR level were directly related to the amount of smoking (pack-years).
The aim of this study was to find out the effects of smoking on renal function study in non-diabetic, normotensive subjects. Impact of smoking on microalbuminuria and urinary albumin creatinine ratio in non-diabetic normotensive smokers. Albuminuria in normotensive and hypertensive individuals attending offices of general practitioners.
Similar rate of progression in the predialysis phase in type I and type II diabetes mellitus.
Diagnostic accuracy of a reagent strip for assessing urinary albumin excretion in the general population.
Prevalence and determinants of microalbuminuria in high-risk diabetic and nondiabetic patients in the heart outcomes prevention evaluation study. Microalbuminuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity. Microalbuminuria in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE study.


Endothelial receptor-mediated binding of glucose-modified albumin is associated with increased monolayer permeability and modulation of cell surface coagulant properties.
Exogenous advanced glycosylation end products induce complex vascular dysfunction in normal animals: A model for diabetic and aging complications. Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. Smoking induces insulin resistance - A potential link with the insulin resistance syndrome.
Insulin resistance and abnormal albumin excretion in non-diabetic first-degree relatives of patients with NIDDM. Insulin resistance and hyperinsulinemia are already present in patients with incipient renal disease. Diminished vascular response to inhibition of endothelium-derived nitric oxide and enhanced vasoconstriction to exogenously administered endothelin-1 in clinically healthy smokers. Acetylcholine-induced coronary vasoconstriction in young, heavy smokers with normal coronary arteriographic findings.
Cigarette smoking is associated with dose-related and potentially reversible impairment of endothelium-dependent dilation in healthy young adults.
Cigarette smoking and serum lipid and lipoprotein concentrations: An analysis of published data.
Advantage to using capillary blood B-hydroxybutyrate determination for the detection and treatment of diabetic ketosis.
Point-of-care blood ketone testing: screening for diabetic ketoacidosis at the emergency department.
The direct measurement of 3-beta-hydroxy butyrate enhances the management of diabetic ketoacidosis in children and reduces time and costs of treatment. After all, to fail the first screening means that one would be subjected to the much more brutal, fast-required, 3-hr glucose tolerance test. I didn't consider myself to have the best (or the worst) eating habits and I knew I had a sweet tooth, but like everyone else I thought to myself "It can't be that bad". At some point the cutoff for calling what is gestational diabetes, just like the differentiation between overweight and obese, is extremely arbitrary.
I wasn't able to get enough blood out of it with the 33 gauge, even when I set the needle intensity (how hard the lance pokes down on the finger) to maximum and poked twice at the same spot. Granted, I did not record my post-snack glucose level since I was running outside all day long. My main concern was that I did not want to starve myself which may lead to excess ketones in the urine.
I have also (sort of) mentally accepted that if all fails, that if there is nothing I can do through diet control to achieve healty food intake and healthy glucose levels, I will accept medication.
Second, the early months of daily throw up and midnight hunger pain caused me to switch from a previously more protein-based diet to a carb-based diet. For every sugary indulgence I had, in my mind I negated it with the next healthy thing I ate, be it a salad, a tofu dish, or some hearty roast chicken. When most folks gain no or drop weight in the first trimester and made up for the baby growth in the third trimester, I gained weight at a steady formula of one pound per week starting week 10. I ate dinner at 7PM, but had a small serving of low fat yogurt at 9PM before I went to bed.
Even the Flax Plus Raisin Bran cereal, which has the highest dietary fiber per serving at my local WholeFoods, has only 8g. I don't feel like I am starving, since I supplement my now low-carb meals with additional snacks.
Measurement of fasting sugar, urea, creatinine, lipids and one time screening of urinary albumin and urinary creatinine was done. Hydroxybutyrate near-patient testing to evaluate a new end-point for intravenous insulin therapy in the treatment of diabetic ketoacidosis in children.
I had a cup of milk and a dried pork bun for breakfast --- in retrospect not the greatest combination for a pre-test meal, went to the hospital, drank 50 grams of glucose, and got my blood drawn an hour later. Every time I went for the prenatal visit, I gained almost exactly, in pounds, the number of weeks since I had last visited them.


I was more worried that I would wake up from hunger or be too dizzy the next day to go to the hospital.
I wasted a lot of test strips on insufficient amounts of blood, and the test strips were the most expensive item. The fibers have been keeping me away from one of my greatest fears in pregnancy discomfort. The dinner was a bit harder to judge, since we ate at a fancy Japanese restaurant and it was a 2-hour meal. My total food intake, on paper, appears to be only a little less from what I was eating before the glucose test.
Urea, creatinine, creatinine clearance, total cholesterol, low density lipoprotein, triglyceride levels were comparable (p = NS). Apparently, no one else besides me have dinosaur skin, because Walgreens does not sell anything but the 33 gauge. I had one bowl of miso soup, 5-6 pieces of sashimi (no rice), 2 pieces of nigiri (has rice), 1-2 bites of grilled fish and chicken, and at the every end ate a small slice of birthday cake.
I am a little unsatiated after main meals, but I have also discovered that this is often because my food digests slower these days, so I always have a delayed satiation response after meals. I know that was because medically, it was way worse to not gain weight, since underweight babies suffer from more complications than overweight babies. I ended up finding the 30 gauge needles from a wholesale website specifically catering to diabetics.
I was OK with going over for the birthday cake, but looks like I was OK because I ate very little carbs beyond that.
In conclusion, smokers have a 4-fold higher prevalence of microalbuminuria than non-smokers.
Perhaps before I was consuming food too much and too fast and with my organs being squeezed into tigher space, I was suffering from indigestion. Among smokers (n = 80), microalbuminuria was directly related to the amount of smoking (pack-years) [Figure 2]. Among smokers (n = 80), urinary ACR level was directly related to the amount of smoking (pack-years) [Figure 5]. PREVEND study [8],[9] showed statistically significant difference in urinary albumin excretion in non-smokers and smokers. Several studies documented that smoking is an independent predictor of (micro) albuminuria in otherwise healthy hypertensive subjects.
The prevalence of microalbuminuria is almost double in smoking than non-smoking lean patients with the primary hypertension.
AGEPs are cross-linking moieties formed from the reaction of reducing sugars and the amino groups of plasma proteins, lipids and nucleic acids. It is known that AGEPs are responsible for enhanced vascular permeability [11],[12] and that they accelerate vasculopathy of end-stage diabetic renal disease. It is reasonable to expect that the AGEPs formed by the reaction of glycotoxins from cigarette smoke with serum and tissue proteins will have the same effect on the systemic and renal vasculature as mentioned. Another mechanism, based on the patho-physiological effect of smoking induced renal damage, is insulin resistance. Several investigators have described smoking to be causally related to insulin resistance in non-diabetic subjects. The plasma concentration of endothelin 14 has shown to be increased in smokers as compared to non-smokers, also indirect evidence available for a disturbance of endothelin, prostacyclin or nitric oxide release on stimulation in smokers. Females have low muscle mass compared with males; therefore, this sex specific difference in ACR is due to decreased urinary creatinine excretion in females. Similarly, smokers have a higher prevalence of 4-fold for microalbuminuria and 16-fold for increased urinary ACR than non-smokers.
Smoking significantly reduces the HDL level; however, no significant effect on serum creatinine and creatinine clearance.



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Comments

  1. 06.11.2014 at 15:45:43


    Glycemic control in older adults snack, that indicates beneficial for blood sugar.

    Author: Kitten
  2. 06.11.2014 at 16:23:57


    Post-meal, the numbers should be less than 180 mg/dl blood sugar.

    Author: BAKU_OGLANI