Pregnancy, Diabetes, and Your Feet

There are so many changes the body undergoes during pregnancy that it becomes easy to ignore the changes in the feet. During pregnancy the body releases hormones that allow the ligaments to relax in the birth canal. The ligaments in the feet also relax, causing the foot to lengthen and widen. Many will complain of a shoe size increase by one or two sizes. In most circumstances, this flattening and widening of the foot is benign and no problems result.
In the diabetic, this change in foot size is important to recognize. Despite the increase in foot size, many moms will continue to wear the same size shoes. As a diabetic, properly fitting shoes are of utmost importance. Increased pressure on the foot can cause areas of rub or irritation and potentially result in ulceration. Once there is an ulceration, one is at risk for infection, delayed healing and further diabetic foot complications.
Diabetic neuropathy is the single greatest risk factor for developing foot ulcerations. Neuropathy is the loss of sensation in the feet commonly caused by diabetes. Many individuals will develop neuropathy before they are diagnosed with diabetes. Others will develop neuropathy years after being diagnosed with diabetes. Luckily, gestational diabetes is not typically associated with neuropathy.
Unfortunately, type I diabetics develop neuropathy much earlier than type II diabetics and may have neuropathy during their pregnancy. Regardless of the type of diabetes, it is still extremely important to have the feet evaluated to assess the status of the nerves. Even mild neuropathy increases the risk of ulceration. Wearing shoes which are too small causes an increase in friction and an increased risk of skin breakdown.
Wearing properly fitting shoes during and after pregnancy is of particular importance. Although the ligaments relax in the foot during pregnancy, they do not stay relaxed. The post-pregnancy foot is at higher risk for developing foot problems. There are multiple reasons contributing to the increased risk. The flattened foot places excess stress on the ligament that holds up the arch. The weight gain from pregnancy places excess stress on the feet. Moms are also carrying their baby, added weight which transmits to the feet. Moms are staying at home more often and walking around in slippers and flexible shoes which are generally not supportive.
To decrease your chances of foot problems during and after pregnancy follow these steps:
1. Check your feet everyday: This is an absolute necessity if you are a type I diabetic or if you have diagnosed neuropathy. It is a good habit to practice. Look for cuts, sores, bruises, openings or areas of irritation. Remember, if your nerves are not functioning properly, then you may not feel everything in your feet. If you cannot reach your feet, have a family member check your feet or place a mirror on the floor and put your feet over it.
2. Check your shoes before you put your foot in them.
3. Don't walk around barefoot: Wear a supportive shoe, one that has a rigid sole and bends only where the foot bends (at the toes). If a shoe seems too confined, find a slipper which has a semi-rigid sole, or try a clog or slip-in shoe with a more rigid sole. The remaining aspect of the shoe can be soft and flexible and allow for swelling, but the sole should be rigid from the heel to the ball of the foot.
4. Buy shoes that fit your feet: Be aware of the changes your feet are going through. The feet are most likely widening and lengthening. Make sure the shoes don't cramp the toes. Your feet will not shrink after the birth.
5. Watch out for folds in your socks: A simple fold can cause rub or irritation on your feet. Swelling will be greater by the end of the day and the small crease that didn't bother you in the morning can rub an open sore or blister on the toes. Serious consequences in diabetics can include ulceration and infection.
6. Dry your feet and between toes after showers: Increased moisture between your toes can lead to skin breakdown and eventual ulceration.
7. Don't be a victim of fashion: Most moms will avoid high fashion during pregnancy, but many try squeezing into that strappy heel after. Wearing high heeled shoes puts excess stress on the ball of the foot, cramps the toes and increases the chances of ankle sprains. Tight shoes will increase the chance of ulceration for those with neuropathy.
8. Test the bath water before stepping in: If you have neuropathy, you will not recognize when the temperature is too hot. Check the water by inserting your hand into the water to wrist depth.
9. Don't use a heating pad on your feet: Although the idea of heat on your feet may sound soothing after a long day, the heat will increase swelling and inflammation. Sore feet respond better to ice. Roll your foot over a frozen sports water bottle to help ease the achiness in the arch. Wear a sock while doing this and don't put ice directly on your feet. The heating pad can cause burns in those who have neuropathy.
10. Don't use any medication on the skin: Be careful of topical medications during pregnancy and during breast-feeding. Consult your doctor before use. Don't use medicated corn pads from the local drug stores if you have neuropathy.11. Visit your podiatrist: At the first sign of a problem, make an appointment with your podiatrist. Prevention is much easier than treatment.

Helpful Hints

- Don't hold your breath. This increases abdominal pressure which feels easier, but prevents you from getting the full benefits of the movement. Take a breath and exhale as you are lifting into the bridge.
- Avoid twisting or turning your trunk. This might cause a side strain and slow your progress.
- Stop if you feel back pain Everyone has their own rate of progression. If you feel pain in your back, stop. Try again on the next workout and you'll find your back will start getting stronger. If back pain continues, stop and consult a fitness professional.
Finish with a stretch
After doing your planks, lie on your back, relax, bend your knees with feet on the floor and tilt them from side to side. Do this a few times to lengthen your back and abdominal muscles.
Strong, flexible abdominal muscles are a moms best friend. Start developing yours today with side planks!

Get Back Your Pre-Pregnancy Abs With Side Planks

The foundation of fitness for a mom is her abdominal area. To moms a flat stomach is wonderful; a strong abdominal core is critical. The cool thing is, you can get both at the same time with side planks.
Side planks are great for toning, without enlarging, the obliques on the side of your abdomen. Strong oblique muscles also add powerful stability to your back. Asthetically, side planks can sculpt your stomach in ways crunches or sit-ups just can't do. The nice thing about side planks is they can be done in little time and you don't need any equipment.
Before we get on to how to do them, I just want to add a little incentive...
A Mom with Poor Abdominal Strength is an Accident Waiting To HappenLet's face it, as your child grows the physical demand placed on your body increases. You start out holding a 8 lb. newborn in your arms, but that quickly changes into holding a 25 lb. toddler who twists and turns quickly.
You may be required to sweep your toddler up with your right arm while holding another child in the left. You may have to carry a 40 lb. child who is unhappy and doing whatever it takes to squirm from your grasp. If your body is incapable of handling these tough physical demands it will let you know, because back pain and fatigue will start compounding. Is your body prepared to handle the stress being placed on it?
A Side Plank A Day Keeps Back Pain AwayPlanks, build functionally strong, stabilizing abdominal muscles that allow you to bend, twist and reach with less chance of injury. Beginning an abdominal strengthening program now will prepare you for when your infant becomes a toddler and for those times your toddler becomes antsy and unruly.
Planks can not only give you back your pre-pregnancy abs, but they will prepare your body to deal with being a mom of a toddler! So let's get to the exercise itself.
How to Side Plank:
1) Begin by lying on your left side. Bend your left elbow and place the forearm on the floor directly under your shoulder. Your weight should be supported on the forearm and the left hip. Your right arm should be resting along the right side of your body with the hand resting on the right thigh.
2) Rise up so your body weight is resting on your left forearm and the edge of your left foot. Wear shoes that have a good edge on the sole to avoid slippage once you're in place. If you find this to be too difficult, start by placing your weight between your forearm and knee. After a few weeks, you'll be able to move to the more difficult position in which you are supporting your body between your forearm and your foot rather than your knee.
3) Lift your body up as high as you can and contract your abdominal muscles by bringing navel to spine. Attempt to form a straight line from your armpit along the side of your ribs to your hip, and down to your ankle just above your left foot. Hold this position for 5 to 10 seconds to start with. You can increase to 20 seconds over several weeks, but your goal should be to eventually build up to at least 60 seconds for each slow contraction.
4) Slowly lower your body back to the floor, then immediately rise as high as you can and hold it again. Repeat on the right side. Start with two sets of 10 repetitions on each side.

Pregnancy and Pre-natal Vitamins

Pre-natal vitamins are important to the health of a growing baby. They are also important to pregnant mothers because their bodies are going through so many changes.
Our diets today are often deficient in key nutrients found in pre-natal vitamins that help a baby's development in the womb. One deficiency that has been found is the lack of enough folic acid, one of the B vitamins.
Rectifying vitamin deficiency can be done by modifying your diet and by taking pre-natal vitamin supplements. It is easiest for your body to absorb nutrients from foods, but since it can be difficult to take in enough of those key vitamins and minerals during pregnancy, most doctors recommend that you also take pre-natal supplements.
The most important pre-natal vitamin is folic acid, which is the synthetic form of the naturally occurring folate. If folic acid is taken in the first four weeks of pregnancy, it can reduce the risk of the baby having an incomplete spinal column, or neural tube defect by up to 70%.
Because folic acid is most useful very early in the pregnancy, most doctors recommend that women trying to conceive begin supplementing their diet with 400 micrograms (mcg) of folic acid per day. In fact the U.S. Public Health Service recommends that all women of childbearing age take this supplement as a preventative measure, in the case of an unplanned pregnancy. Many once-daily multi-vitamin supplements include this in their product.
While folic acid is most important in the first trimester, most doctors recommend it throughout the pregnancy. Spinach and chicken liver are great natural sources of folate. Folate is often added to breakfast cereals and breads; this addition will be written on the nutrition label.
Calcium is another critical supplement for your baby for the same reasons that it is important for you; calcium helps the baby develop strong bones and teeth. One of the best sources of calcium is cheddar cheese (real cheese, not the plastic-like "cheese product" made from hydrogenated oil with orange color added). Calcium is also found in yogurt, milk, kale, etc.
In addition to dairy products, calcium citrate is often added to cereals and other non-dairy products like orange juice.
When taking calcium supplements it may be safest to take calcium citrate which is made from citrus fruit.
Small amounts of vitamin D are important for calcium absorption. The good news is that you can absorb this vitamin through exposure to the sun. Most prenatal supplements provide this vitamin.
Iron is important for the baby's development of red blood cells, which deliver oxygen to the baby. Supplementing iron into your diet is mostly important for the mother's health. Insufficient iron might lead to fatigue and anemia. On the other hand, too much iron can hurt both the mother and the baby. Be very careful with iron supplements!
The baby will generally get all of the iron he needs, even if that means leaving the mom anemic. By the end of the pregnancy a mother will have twice as much blood in her body as she did before. Therefore pregnant women may need more iron as non-pregnant women. Another important fact is that coffee and tea can decrease iron absorption.
The best and safest way to get the right amount of iron is to take the balance multi-vitamin and mineral pre-natal supplements that your doctor recommends. You might save money if you ask your doctor which over the counter pre-natal vitamins may contain the same ingredients as prescription versions.
Pre-natal vitamin supplements are even more important for women who have poor nutrition, women who are carrying twins, and women who have a closely spaced pregnancy.
For women that are healthy and eat a balanced diet, pre-natal supplements are still important to insure against the possibility that the women are not getting enough of any given nutrient. Many women who were careful to eat right were still found to be low in folic acid for example.
Vitamin supplements, in particular those with iron, can be tough to swallow for the expecting mother because of the infamous 'morning sickness,' that is far from relegated to the morning hours.
Many women have found that beginning to take pre-natal vitamins a month or more before conception can diminish morning sickness and therefore make taking the pre-natal vitamins during pregnancy an easier pill to swallow. Taking prenatal vitamins when you are not pregnant does not cause any problems. These vitamins are not that different than regular daily multi-vitamins, except that they do not contain any herbs or herbal supplements that could cause problems. Be very careful to avoid most herbal supplements when pregnant. Talk to your doctor.
Note: These statements have not been evaluated by the Food and Drug Administration. Supplements are not intended to diagnose, treat, cure, mitigate or prevent any disease. All information here is intended for general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and always consult your doctor before starting any new supplement, diet or fitness regimen.

Glutathione for a Healthier Pregnancy

All parents-to-be nurture the dream of a healthy pregnancy and baby.
But the modern environment and diet is deficient in many factors essential for the health of mother and fetus. One of those factors is antioxidants.
The role of antioxidants like folic acid in preventing birth defects like spina bifida and cleft palate is well known. It is now included in all prenatal vitamin supplements.
But the role of antioxidants like glutathione and Vitamin E in pregnancy is often overlooked.
Antioxidants and glutathione status play an important role in the development and growth of the fetus, maintenance of a healthy pregnancy - and even before pregnancy, in fertility and conception.
Glutathione is the body's master antioxidant. It helps to regenerate stores of other antioxidants like Vitamin C and E.
It also protects both mother and fetus from the damaging effects of free radicals and oxidative stress.
Many pregnancy complications and birth defects have been linked to oxidative stress, free radical damage and low glutathione levels in the mother and fetus.
The role of glutathione in the development of the foetus and placenta is crucial. Glutathione (GSH) can control cell differentiation, proliferation, and cell death - essential functions in the developing embryo.
In the placenta, glutathione detoxifies pollutants before they reach the developing child. Most substances or factors which cause birth defects (teratogens) are known to exert their embryotoxic effects because they cause oxidative stress.
The human placenta possesses a significant amount of glutathione S-transferase (GST) capable of detoxification or activation of drugs and pharmaceuticals during the critical period of organ development in the fetus.
Some drugs are known to cause birth defects in the growing fetus by generating free radicals, and depleting GSH stores.
In the early embryonic stages, the fetus is sensitive to the toxic and teratogenic effects of chemicals, whereas it is sensitive to carcinogenic effects during late fetal stages.
Carcinogens administered to the mother can be transferred through the placenta and induce cancer in the fetus. Many carcinogens are much more active in the fetus than in adults and they tend to act as abortifacients and teratogens as well.
Environmental and lifestyle factors are known to cause oxidative stress and lower glutathione levels - resulting in birth defects, abortion and miscarriages in pregnancy.
Some of the known teratogens (causing birth defects) in pregnancy include:
o Radiationo Pesticides and Persistent Organic Pollutants (POPs)o Air pollutiono Heavy metals (mercury, cadmium, arsenic)o Vinyl chlorideo Acryonitrileo Excess Oxygen (hyperoxia)o Anti-psychotic and anti-epileptic drugs (AEDs)o Thalidomideo Cigarette smokeo Alcohol (ethanol) consumption
Maternal health factors that increase free radicals and cause birth defects include:
o Diabeteso Pre-eclampsiao Infection and Inflammation
Glutathione and other antioxidants attenuate oxidative stress in pregnant women with inflammation or maternal conditions like diabetes and pre-eclampsia, and in fetuses at risk for developing cystic fibrosis.
Supplementation with glutathione precursors and antioxidants can decrease the incidence of birth defects and protect both mothers and the fetus from the damaging and possibly fatal consequences of pregnancy complications.
Glutathione (GSH ) also prevents or minimizes the oxidative stress that occurs during labor and the birth process.
Perinatal or birth asphyxia/hypoxia (deprivation of oxygen supply to the brain) in preterm deliveries and labor can lead to cerebral palsy, respiratory distress syndrome, irreversible brain injury, and permanent neurological and intellectual handicaps.
Administration of the glutathione precursor, N-Acetyl-Cysteine (NAC), to the pregnant mother partially prevents oxidative stress during the birth process in premature infants.
Currently, the American College of Obstetrics and Gynecology advises all pregnant women to take a prenatal vitamin containing antioxidants.
In addition, they advise eating lots of fresh fruits and vegetables, the best sources of antioxidant protection.