How to Avoid Gestational Diabetes with Lily Nichols



today we are talking all about pregnancy I know it's fertility TV but we're talking about pregnancy hi everyone this is mark's florida fertility expert and welcome back to fertility TV today we're actually talking about just a tional diabetes and I have an amazing guest Lillie Nichols is here who has been with us in the past talking about this exact same topic but today we're going to go and talk about it in a slightly different way so welcome Lillie thanks so much for joining I appreciate your time again yeah thanks for having me mark yeah so um you know I can't assume that everyone has watched our previous interview so let's tell everybody a little bit about you and and how you got into gestational diabetes sure I actually got into gestational diabetes back in gosh in sort of research bill I worked for the state of California for a program that where we helped trained healthcare practitioners on diagnosing and treating gestational diabetes and sort of wrote the public policy for the state and then later worked in clinical practice with women with gestational diabetes and it was there that I was kind of able to get out of research land and you know into a practitioners seat and see what works in clinical practice and put into play you know the conventional guidelines nutrition guidelines for gestational diabetes and with gestational diabetes you know it's elevated blood sugar and pregnancy and food is the number-one thing that you do to help manage it before you go to medication or insulin or anything like that and it was really interesting to be in that role kind of going at it from a reverse angle because I realized that the conventional guidelines don't work very well at the table and you know about 40% of women end up feeling the diet for gestational diabetes and I was like what are they really failing the diet or the diet fail them because the conventional diet is pretty high in carbohydrates and carbohydrates are the main nutrient that raises your blood sugar so it would make sense you should maybe consider going lower carb but there was a lot of you know pushback against that in the conventional community so it took a lot of a lot of research on my end to understand what's safe and what's not safe in pregnancy and I eventually developed my real food approach to managing gestational diabetes which is nutrient dense and lower carbs so not only are you not pushing the blood Sugar's high with excessive carbohydrates but you're also providing a lot of nutrients that match naturally helps with blood sugar balance and of course help for optimal development of their baby so that eventually led to my book real food for gestational diabetes which we talked about in our previous interview yeah awesome book yeah thank you and and yeah that's the approach I teach that's what I do that's great yeah you know really anytime here in the office that I need to refer to to talk about just a tional diabetes and hopefully I'm catching them before they get there but you know your book is the book that I send everybody to so I love it and refer to it quite on yeah so if you're watching two things you can go ahead and watch our previous interview because we go into a lot of detail on the book and on just a tional diabetes but also if you might be one of those individuals who might be predisposed to it then pick up the book and start learning about it now so that you're ahead of the curve so Lily so for those women watching and maybe they're even watching with their husbands which would be awesome if they don't know much about gestational diabetes and they're trying to learn a little bit about it see if they are if they have it or anything like that can you give a short intro or understanding of what gestational diabetes is yeah so just a tional diabetes there's a couple different ways to define it but essentially it is high blood sugar that either first develops or is first diagnosed in pregnancy which opens up a bit of a can of worms something that is caused by I like the change in hormones which affect your body's insulin response and weight gain during pregnancy or it could be that you had maybe mild pre-diabetes going on pre pregnancy or other things like PCOS if you start your pregnancy at a higher weight those can affect your your insulin response so it takes into account kind of a broad spectrum but essentially if your blood sugar goes beyond a certain threshold in pregnancy then you get the diagnosis of gestational diabetes regardless of when it started or the exact cause yeah and I think it's also important for anyone out there who's watching who thinks that well you know I'm not overweight and I'm lean and you know I'm healthy and I eat well whatever that they might say oh well there's no way that I'm going to catch this I see it oh well I can't I say catch it like you know it's a cold it's not I'm you know I should say I get it right I see this all the time as you know a misstep on patients do you do that with the patient population that you work with as well yes absolutely and in fact when I was back working in public policy one of the things that is hotly debated as the best way to diagnose gestational diabetes and the screening protocol in the US I know everybody like everybody hates the glucose tolerance test the glucose sweet thing yeah I mean I kind of hate it too I totally get it um but the way that we do the glucose tolerance tests in the US but most doctors do it is different than the rest of the world and is less evidence-based so if we actually saw what the rest of the world does this is it's a single-step glucose tolerance test as an intermediate amount of glucose and it's a fasting test and there's different thresholds for what time what's not we actually diagnosed that probably about double the amount of women with gestational diabetes we're catching or women who have like mild gestational diabetes which i think is great because you can usually do so much more you go fishin for those people but it does make the actual like diagnostic rate higher and I don't think that's a bad thing because what we're discovering now is gestational diabetes or high blood sugar and pregnancy even below the diagnostic threshold of gestational diabetes affects the baby's development we're finding there's significant research study came out of Stanford showing significantly higher rates of congenital heart defects in babies born to moms who had that slightly elevated blood sugar we're seeing you know race of Macker Omiya when the babies grow too large not because they're super healthy because they're like just putting on too much fat actually we find that and women's who have just mildly elevated blood sugars it doesn't take a huge surge to have effect so I think it's not necessarily a bad thing to diagnose more women if they're given the option for more proactive treatment and we know that you know women eating a lower glycemic diet their chances of requiring insulin are cut by 50% if they're any better you know they're not getting poor nutrition advice so I think we could do a lot to a lot more preventive care if we catch it yeah we could do a lot more preventative care across the board I think oh yeah um the you know blood sugar management is a huge epidemic that's happening across the world and I'd say you know for sure in the US and it's leading to so many things so we know that's an issue with gestational diabetes can you maybe give a short list of what might be the common causes for gd4 everyone who's watching yeah meaning predisposing risk factors um you know starting so we mentioned PCOS earlier so usually with PCOS you have on you know some some level of insulin systems going on if you come into pregnancy with insulin resistance already and then pregnancy naturally screws up your insulin resistance towards the end for good reason to try to shunt nutrients to the baby but kind of works against us and in our modern times that's definitely a risk factor being overweight prior to becoming pregnant again that affects your insulin sensitivity so that's a predisposing factor just being an older woman and not like very old literally like above 25 here at a higher risk because usually influence sensitivity goes down as you get older if there's any family history of diabetes again that's going to be a predisposing factor and then if you're from an ethnicity where type 2 diabetes is common like pretty much all the same risk factors for type 2 diabetes are the same as with gestational diabetes so that that alone puts you at risk and that's completely out of your control unfortunately and then we're finding there's like some little niggly things that can affect it like lifestyle things during your pregnancy so eating a lot of higher glycemic carbohydrates sort of stresses out your pancreas more than it needs to you just are forcing your body to produce more and more and more insulin you kind of burn out your pancreas a little bit pregnancy so they've shown women who do a lot of like fruit juices and cereals and other things early in pregnancy tend to have a higher rate of gestational diabetes gaining too much weight during pregnancy again it's all about insulin sensitivity and that effects it awesome that's an awesome kind of overview for everyone who's listening and like I said earlier if you want more detail than lily and I did a really good extensive interview previously right and I should also say some women have no risk factors at all so if you're saying there's like these people like below no make it a tasteful healthy and really thin what's going on there's like 50 percent or something of women don't have any traditional risk factors and they they still end up you know having high blood sugar and pointing to that you know just it's not always something you did to cause it everyone wants to like point the finger at themselves and like I did this to myself and not necessarily there's sometimes there's these things that are out of your control so yeah it's good to to recognize that now so if if someone who's watching thinks they might have it they know they have gestational diabetes or they want to be proactive about it you know the first thing and we talked about this and the previous interview will have a link to that in the notes on this one is you know just referencing your book that you showed us previously but I know that and one of the reasons I brought you on on to again for an interview was to really go over your program you created a an online program that is based on your book right can you let us know just kind of like a little overview about that yeah so the program shares the same name real food for gestational diabetes easy and it's an online course that walks you through pretty much everything you need to know I have thought when I was writing the book that this was like you know super comprehensive and we're covering everything and it gives you everything you need and then realized after getting so much more inquiry into one-on-one work with me that like okay people need a lot more support around this most women you know it's rare if you have a pregnant friend at the same time that you can you know share ideas with but to find somebody who also has gestational diabetes and knows what it's like to have to check your blood sugar four times a day and carry around supplies and not be able to eat everything you want and give in to every single craving without worry like it's nice to have somebody there to go through the program with you so it's a fully online programs there are you know I give you all the information about checking your blood sugar instead of just reading through it you have like me demonstrating on my poking my own finger if you know how to check how to interpret the numbers there's a lot of handouts that also go along with it that kind of walk you through things like you know a questionnaire to fill out before you're going to doctor's appointments to make sure your questions answered how to converse with your doctor because you know if you're following my approach it might be different than what their nutritionist recommends so there are certain things that you need to be kind of upfront with your doctor about I've expanded the meal plan so in my book I have you know a few days of meal plans and in the online course I have 21 days of meal plans so 3 different levels of carbohydrates and walk you through how to you know customize the right figure out what's the right amount of carbohydrates for you and sort of customize your own meal plan so there's just a lot more resources to go along with the information that you would get in the book and of course there's you know food video lessons where you're actually seeing like what is a normal sized portion of carbohydrates so you know kind of how much you can get away with a little more carbon tolerance like what's the actual portion of fruit look like some of these things are visual things that are best done in person or in video that's really hard to convey on paper there's a whole section on medication exercise I recorded exercise videos while I was pregnant so you can see me doing they're mostly Pilates exercises and as a Pilates teachers you know previously so it's really helpful just for your not only for your blood sugar but your own well-being to know you know how to move your body and and keep good posture so you feel good have an easier labor can recover from childbirth and you know refined your pelvic floor muscles and your abdominal muscles after you've been through birth there's a whole section on medication some of the research has updated since I wrote the book so there's you know additional information there and then there's a bonus section the most popular bonus I have is a full training on lowering fasting blood sugar naturally so that's kind of the the trickiest number it's really easy to tweak your post meal numbers by just reducing the amount of carbohydrates you eat for not art but fasting blood Sugar's the tricky one and a lot of women end up on medication specifically for their fasting blood sugar which isn't a bad thing however sometimes there are things you can do nutritionally and with your lifestyle to bring your fasting blood sugar down sometimes you know 10 15 even 20 points in some women so if you want the best chances to go about managing your blood sugar naturally and maybe not requiring medicine that's a really helpful interview to go through because you know worked probably more than any other dietitian I've really worked one-on-one with a lot of women to see what works and what doesn't so I kind of walk you through like what to try first what to try second much try third it goes beyond just eating a snack before you go to bed and then finally there's also a support group Facebook group that goes with it and I have weekly office hours in there so if you have questions you tried out some things for your fasting blood sugar not sure what you should try next like you can actually get my input on the spot and then you know connect with other women in the group so it's really great to just have that support network as well that's great I mean just that that alone that that group and with your you know weekly office hours that alone is is worth it and valuable so yes because the only way it has I have very you know I have a baby myself so I have very limited clients time and the course is less than a single hour consult with me cost wise so and you can have ongoing weekly check-ins with me if you want yeah office hours in the Facebook group but you also get feedback from the other women which i think is is huge because sometimes they have their own stories to share like one gal recently shared in our group about I'm her glucose meter like the one that she had was not as accurate and we had a whole discussion about like the most accurate glucometer and it was even some she brought up some points that you know I hadn't seen before when you work in clinical practice oftentimes you recommend one meter it turned out the meter that she found that worked best was the one that I had always used in practice so like I hadn't run into women having ridiculously different blood sugar but her blood sugar was like 20 points different on one meter versus another the one that was more accurate so that could be the difference between requiring medication or not you know like ridiculous you know so little things like that it's really cool to have you know this group to to be in and they learn from me I learned from them and it's an awesome you know way to to be connected yeah I'm sure no I mean that's super valuable aside from all the different modules that you have on different sections and and probably like like myself with my programs the ability to update those ongoing way exactly which is nice you can't quite do that with the book so I know there's no one-size-fits-all and I know that everybody wants or needs different things why would someone pick and say you know what I'm going to read the book instead of doing your program where I'm going to do the program instead of getting the book and so forth well what's interesting is I found that most the people who join the program already have the book and a lot of times they're either looking for more support like the camaraderie of a group or maybe my feedback on things definitely additional information on fasting blood sugar and and things like meal plans more meal plans more recipes more ways to put what's in the book into action so I think the real go-getter is maybe people who just have kind of like mildly elevated blood sugar but they implement a couple things in the book they see the blood sugar go down easy peasy then just use the book you know you're fine if you're kind of borderline with your blood sugars you're worried you might need medication or you simply want my feedback or to connect with course defense I think that is I'm definitely more helpful to be in the course plus you get lifetime access so you know now we're in our like second year of running the course so a lot of women have had their babies or maybe moving on to have their second baby so there are you know I'm also a nursing mom so if you have questions about breastfeeding most of us in the group are also breastfeeding so that's a really good place to get quick support on that when you're nursing you like once you need feedback right away you can like wait a day or two days or three days to see a lactation consultant sometimes so just getting that peer support is good but also for women who are having their second baby you're in the course for life and we know that the recurrence of gestational diabetes in the next pregnancy is pretty pretty high that the Testaments always change you know the statistics on it depending on the latest studies but I've read anywhere from 40 to 70% recurrence rate so if you know you're going to have you know blood sugar issues in the next pregnancy and again even if they're like slow the diagnostic threshold but are kind of borderline it's a really good thing to keep an eye on especially early in pregnancy so you have the course to return to you have the support group on your hands so it's like a one-time investment and it can be with you for your whole you know reproductive oh yeah all your pregnancies and all exactly cool well either way if you decide to pick up the book or check out Lily's program I do think that if you you know fit the bill and you fit into one of those categories and criterias that might cause you to pre be predisposed to gestational diabetes I really highly recommend checking out one of those two resources for yourself and getting a jump start and the sooner you do it the better it's only going to help you get it to the control faster so I do encourage you all to do that Lily thank you so much for for joining me again today I appreciate it I'm sure everyone who's listening does and like I said we'll put a link to both the interview and the program for Lily as well and you guys can check that out you know in the notes of the comment section below and in the blog post as well thanks so much Lily any last words you want to say um yeah you know for for anyone who wants to learn more either about the book or the course I do have a free video series over at real food for GD comm and it's three videos and they walk you through sort of the basics of checking your blood sugar so if you want to take the proactive approach and monitor your blood sugar early on I give you the thresholds and you know a tracking sheet and everything and then walk you through some common mistakes dye mistakes that women make with gestational diabetes and I do talk more about the court within the video series as well so that'll just help you kind of make the decision for yourself and see if it's right for you cool thanks so much everyone go on to the website check out her video series and find the resource that fits you best I'm Lily thanks so much I appreciate it and I'm sure that everybody listening does as well thank you Mark yeah my pleasure until next time everyone we will see you on fertility TV alright alright are you looking for more information on how to improve your fertility tips useful information how to's words of encouragement then you need to be part of my community you can send it from my newsletter right here you

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