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What I need to know about Preparing for Pregnancy if I Have Diabetes
On this page:
- Introduction
- Taking Care of Your Baby and Yourself
- Your Diabetes, before and during Your Pregnancy
- My Blood Glucose Levels
- My Ketone Levels
- My Checkups
- Smoking
- Eating, Diet, and Nutrition
- My Physical Activity Routine
- My Medicines
- Changes in My Daily Routine
- Planning to Breastfeed My Baby
- Pregnancy and Diabetes: Checking Your Baby's Health
- Labor and Delivery with Diabetes
- After Your Baby Arrives
- Points to Remember
- Hope through Research
- Pronunciation Guide
- For More Information
- Acknowledgments
- My Plan to Prepare for Pregnancy with Diabetes
- My Daily Blood Glucose Monitoring Times
- My Target Blood Glucose and A1C Numbers
- My Plan to Check for Ketones
- My Daily Physical Activity Record
- My Daily Blood Glucose Record
- My Daily Food Record
If you have diabetes,* the best time to control your blood glucose, also called blood sugar, is before you get pregnant. High blood glucose levels can be harmful to your baby during the first weeks of pregnancy—even before you know you are pregnant. Blood glucose targets are different for women who are trying to get pregnant. Targets are numbers you aim for.
Pregnancy and new motherhood are times of great excitement and change for any woman. If you have type 1 or type 2 diabetes and are hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy. If you have diabetes and are already pregnant, don't panic! Just make sure you are doing everything you can to take care of yourself and your diabetes during your pregnancy.
For Women with Gestational Diabetes
Read more about gestational diabetes, a type of diabetes that develops only during pregnancy, in What I need to know about Gestational Diabetes at www.diabetes.niddk.nih.gov.
*See Pronunciation Guide for tips on how to say the words in bold type.
If you have diabetes, your pregnancy is considered high risk, which means you have an increased risk of problems during your pregnancy. You need to pay special attention to your health, and you may need to see doctors who specialize in treating diabetes or its complications. Millions of high-risk pregnancies, such as those in which women are older than 35 or carrying two or more babies, produce perfectly healthy babies without affecting the mother's health.
Taking Care of Your Baby and Yourself
Keeping your blood glucose as close to normal as possible before and during your pregnancy is the most important thing you can do to stay healthy and have a healthy baby. Your health care team can help you learn how to use meal planning, physical activity, and medicines to reach your blood glucose targets. Together, you'll create a plan for taking care of yourself and your diabetes.
Pregnancy causes a number of changes in your body, so you might need to change how you manage your diabetes. Even if you've had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. As you get closer to your delivery date, your needs might change again.
How Diabetes Can Affect You and Your Baby
High blood glucose levels before and during pregnancy can
- worsen your long-term diabetes problems, such as eye problems, heart disease, and kidney disease
- increase the chance of problems for your baby, such as being born too early, weighing too much, having breathing problems or low blood glucose right after birth, or other health problems
- increase the risk of your baby having birth defects
- increase the risk of losing your baby through miscarriage, which means loss of the baby before 20 weeks, or stillbirth, which means the baby dies in the womb after 20 weeks
However, research has shown that when women with diabetes keep blood glucose levels under control before and during pregnancy, the risk of birth defects is about the same as in babies born to women who don't have diabetes.
Glucose in a pregnant woman's blood passes through to the baby. If your blood glucose level is too high during pregnancy, so is your baby's glucose level before birth. After delivery, however, the baby's glucose level may drop quickly and go too low.
Having diabetes can also increase your chances of developing the following conditions:
- Preeclampsia is a condition in which you develop high blood pressure and too much protein in the urine during the second half of pregnancy. This condition can cause serious problems for you and your baby that can be life threatening. The only cure for preeclampsia is to give birth. If you develop preeclampsia late in your pregnancy, you may need to have surgery—called a cesarean section, or c-section—to deliver your baby early. If you develop preeclampsia earlier, you may need bed rest and medicines, or you may have to be hospitalized, to allow your baby to develop as much as possible before delivery.
- Depression can make you too tired to manage your diabetes and care for your baby. If during or after your pregnancy you feel anxious, sad, or unable to cope with the changes you are facing, talk with your doctor. Depression is a treatable illness. Your doctor can suggest ways you can get help and support.
Your Diabetes, before and during Your Pregnancy
As you know, in diabetes, blood glucose levels are above normal. Whether you have type 1 or type 2 diabetes, you can manage your blood glucose levels and lower the risk of health problems.
A baby's brain, heart, kidneys, and lungs form during the first 8 weeks of pregnancy. High blood glucose levels are especially harmful during this early stage. Yet many women don't realize they're pregnant until 5 or 6 weeks after conception. To protect your baby's health, work with your health care team to get your blood glucose under control before you get pregnant.
If you are already pregnant, see your doctor as soon as possible to make a plan for taking care of yourself and your baby. Even if you learn you're pregnant later in your pregnancy, you can still do a lot for your health and your baby's health.
Use a Planning Checklist
You can use the planning checklist "My Plan to Prepare for Pregnancy with Diabetes" and other tools at the end of this publication to help you plan for and have a safe and healthy pregnancy. The planning checklist includes the same topics that are discussed in the following sections. Tackle one thing at a time to keep from feeling overwhelmed. Your health care team can help you with tasks that are difficult for you.
Planning Ahead
Before you get pregnant, talk with your doctor about having a baby. Your doctor can help you make sure your blood glucose levels are on target and give you the care and information you need to prepare for pregnancy.
If you are thinking about getting pregnant, you can take these steps:
- If you have questions or worries, discuss them with your health care team.
- If you're overweight, talk with your doctor about losing extra weight before you get pregnant.
If you're not ready for pregnancy, talk with your doctor about how to delay getting pregnant until you are ready.
My Health Care Team
Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure you get the best care. Your health care team may include
- a medical doctor who specializes in diabetes care, such as an endocrinologist or a diabetologist. You will need monitoring and advice on glucose control during and after your pregnancy.
- an obstetrician-gynecologist, or OB/GYN, who has experience treating women with diabetes. Ask for a referral if your current gynecologist does not also deliver babies. You may be referred to a maternal-fetal medicine specialist, also called a perinatologist. These doctors are OB/GYNs who have had special training to take care of women with high-risk pregnancies. You will see your OB/GYN regularly throughout your pregnancy.
- a nurse educator or nurse practitioner, who provides prenatal care and advice on managing diabetes.
- a registered dietitian to help with meal planning. A healthy diet—for glucose control and nutrition—has never been more important than now. The phrase "You're eating for two" is not about quantity as much as food choices.
- specialists who diagnose and treat diabetes-related problems, such as ophthalmologists and optometrists for vision problems, nephrologists for kidney disease, and cardiologists for heart disease. If you are already experiencing problems from diabetes, you'll need those conditions monitored throughout your pregnancy.
- a social worker or psychologist to help you cope with stress, worry, and the extra demands of pregnancy. You may already have this kind of support, or you may need it suddenly. If anxiety mounts or you become depressed, tell your OB/GYN. Ask for a referral if you need help working through issues during your pregnancy or after your baby is born.
- a doctor who cares for children, called a pediatrician. You might want to ask friends, family, or your health care team for recommendations. Many pediatricians visit their newest patients at the hospital soon after their birth.
- a doctor who cares for newborn babies, called a neonatologist. The hospital will assign a neonatologist if urgent care for your baby is needed at the hospital.
- a lactation consultant, who is trained to help with breastfeeding. She can give you the information and support you need to start breastfeeding your baby.
You are the most important member of the team. Your health care team can give you expert advice, but you'll be responsible for keeping your diabetes under control every day.
My Blood Glucose Levels
Daily Blood Glucose Levels before Pregnancy
If you are thinking about getting pregnant, talk with your doctor about what your blood glucose targets should be as you get ready to have a baby. Find out when and how often you should check your daily blood glucose levels with a blood glucose meter. If you already check your blood glucose levels, you may need to check them more often than you do now.
The following chart shows target blood glucose numbers for women with diabetes who are planning to become pregnant.
|Target Blood Glucose Numbers (mg/dL) for Women with Diabetes Planning to Become Pregnant
|Before meals and when you wake up
|80 to 110
|1 to 2 hours after eating
|100 to 155
Daily Blood Glucose Levels during Pregnancy
During your pregnancy, you'll check your blood glucose levels using a blood glucose meter several times a day. Most doctors recommend testing at least four times a day. Talk with your doctor about when you should check your blood glucose levels and check off the times using the checklist included under "My Daily Blood Glucose Monitoring Times."
Getting correct results from your meter is important. Follow the directions for using your meter and take care of your meter. Recheck your blood glucose level if a test result seems off. Ask your health care team for help if you have questions about using your meter or your test results.
The daily target blood glucose numbers recommended by the American Diabetes Association for most pregnant women are in the following table.
|Target Blood Glucose Numbers (mg/dL) for Women with Diabetes Who Become Pregnant
|Before meals, at bedtime, and overnight
|60 to 99
|1 to 2 hours after eating
|100 to 129
Ask your doctor what targets are right for you. Write down your targets in "My Target Blood Glucose and A1C Numbers."
You can keep track of your blood glucose levels using "My Daily Blood Glucose Record." Write down the results every time you check your blood glucose. Your blood glucose records can help you and your health care team decide whether your diabetes care plan is working. You also can use this form to make notes about your insulin and ketones.
The A1C Test
Another way to see whether you're meeting your targets is to have an A1C blood test. Results of the A1C test reflect your average blood glucose levels during the past 3 months. The American Diabetes Association now recommends that most women with diabetes should aim for an A1C target as close to normal as possible—below 7 percent, and ideally below 6 percent—before getting pregnant and during pregnancy. Your doctor can help you set an A1C target that is best for you. Write your target under "My Target Blood Glucose and A1C Numbers."
Low Blood Glucose
When you're pregnant, you're at increased risk of having low blood glucose, also called hypoglycemia. When blood glucose levels are too low, your body can't get the energy it needs. Although hypoglycemia can happen suddenly, it is usually mild and can be treated quickly. Eating or drinking something with carbohydrates—sugars and starches found in many foods—can bring your blood glucose level back to normal. Left untreated, hypoglycemia can make you pass out.
Low blood glucose can make you
- hungry
- dizzy or shaky
- confused
- pale
- sweat more
- weak
- anxious or cranky
- have headaches
- have a fast heartbeat
Low blood glucose can be caused by
- meals or snacks that are too small, delayed, or skipped
- doses of insulin that are too high
- increased physical activity
Low blood glucose also can be caused by drinking too many alcoholic beverages. However, women who are trying to get pregnant or who are already pregnant should avoid drinking alcohol.
Read more about low blood glucose in Hypoglycemia at www.diabetes.niddk.nih.gov.
Using Glucagon for Severe Low Blood Glucose
If you have severe low blood glucose and pass out, you'll need help to quickly bring your blood glucose level back to normal. Your health care team can teach your family members and friends how to give you an injection of glucagon, a hormone that raises blood glucose levels right away. If glucagon is not available, someone should call 911 to get you to the nearest emergency room for treatment.
High Blood Glucose
High blood glucose, also called hyperglycemia, can happen when you don't have enough insulin or when your body isn't able to use insulin correctly. High blood glucose can result from
- not taking your diabetes medicines
- eating more food than usual
- being less active than usual
- illness
- stress
Also, if your blood glucose level is already high and you have chemicals called ketones in your blood or urine, physical activity can make your blood glucose level go even higher. Symptoms of high blood glucose include
- frequent urination
- thirst
- weight loss
Talk with your doctor about what to do when your blood glucose is too high. Your doctor might suggest a change in your insulin, meal plan, or physical activity routine.
My Ketone Levels
When your blood glucose is too high or if you're not eating enough, your body might make ketones. Ketones in your urine or blood mean your body is using fat for energy instead of glucose. Your body can't use glucose for energy if you don't have enough insulin or you aren't getting enough glucose from food, so it uses fat instead. Burning fat instead of glucose can be harmful to your health and your baby's health. Harmful ketones can pass from you to your baby. Your health care team can teach you how and when to test your urine or blood for ketones.
If ketones build up in your body, you can develop a condition called ketosis. Ketosis can quickly turn into diabetic ketoacidosis, which can be life threatening. Symptoms of ketoacidosis are
- stomach pain
- nausea and vomiting
- frequent urination or frequent thirst, for a day or more
- fatigue
- muscle stiffness or aching
- feeling dazed or in shock
- rapid, deep breathing
- breath that smells fruity
Checking Your Urine or Blood Ketone Levels
Your doctor might recommend you test your urine or blood daily for ketones or when your blood glucose is above a certain level, such as 200 mg/dL. If you use an insulin pump, your doctor might recommend that you test for ketones when your blood glucose level is unexpectedly high. You can write down the times you should check for ketones in "My Plan to Check for Ketones."
You can prevent serious health problems by checking for ketones as recommended. Talk with your doctor about what to do if you have ketones. Your doctor might suggest making changes in the amount of insulin you take or when you take insulin.
My Checkups
Your diabetes-related health problems can affect your pregnancy. And pregnancy can make some diabetes health problems worse. Your doctor can talk with you about how pregnancy might affect any previous or ongoing problems you have. If you address these problems enough in advance, you may decide to work with your doctor to arrange for treatments, such as laser treatment for eye problems, before you get pregnant.
Before you get pregnant, talk with your doctor about
- whether your vaccinations—shots to help prevent diseases—are up to date
- having a Pap test to check for changes in the cells of your cervix, the lower part of the uterus that opens into the vagina
- being checked for sexually transmitted diseases and HIV
Have a complete checkup before you get pregnant or at the start of your pregnancy. Your doctor should check for
- high blood pressure, also called hypertension
- eye disease, also called diabetic retinopathy
- heart and blood vessel disease, also called cardiovascular disease
- nerve damage, also called diabetic neuropathy
- kidney disease, also called diabetic nephropathy
- thyroid disease
Also, let your doctor know about
- prior pregnancies
- health problems that run in your or your partner's family
- family or social situations that could hurt your and your baby's safety, such as domestic violence or lack of support
- other health problems you have, such as an eating disorder or depression
You'll also get regular checkups throughout your pregnancy. During these visits, your health care team will check your blood pressure and A1C levels and monitor the protein in your urine.
Smoking can increase your chance of having a stillborn baby or a baby born too early. Smoking is especially harmful for people with diabetes. Smoking can increase diabetes-related health problems such as eye disease, heart disease, kidney disease, and amputations. If you smoke, talk with your doctor about how to quit.
Eating, Diet, and Nutrition
A healthy eating plan is important as you prepare for and go through pregnancy. A healthy eating plan will help you manage your blood glucose levels and weight.
If you don't already see a dietitian, you should start seeing one before you get pregnant. Your dietitian can help you learn what to eat, how much to eat, and when to eat to reach or maintain a healthy weight. These habits are important to learn for your and your baby's future. Together, you and your dietitian will create a healthy eating plan tailored to your needs, usual schedule, food preferences, medical conditions, medicines, and physical activity routine.
During pregnancy, many women need changes in their diet, such as extra calories and protein. You might need to see your dietitian every few months during pregnancy as your needs change. Eating a well-balanced diet helps ensure that you and your baby are healthy.
How Much to Eat
Talk with your dietitian about how many servings to have at each meal and snack. Your dietitian can also provide advice about portion sizes.
Once you are pregnant, your healthy eating plan will be based on how many calories you need for pregnancy and your goals for weight gain during the pregnancy. Work with your health care team to gain the right amount of weight during pregnancy. Weight gain during pregnancy depends on your weight before pregnancy:
- Women who were underweight before pregnancy should gain 28 to 40 pounds
- Women who were normal weight before pregnancy should gain 25 to 35 pounds
- Women who were overweight before pregnancy should gain 15 to 25 pounds
- Women who were obese before pregnancy should gain 11 to 20 pounds
However, your doctor may recommend a slightly different weight gain goal for you.
You'll need to find out your body mass index (BMI) number to know whether you are underweight, normal weight, overweight, or obese before pregnancy. Online BMI calculators are available at www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm and www.cdc.gov/healthyweight/assessing/bmi.
Vitamin and Mineral Supplements
Your doctor will tell you whether you need to take a vitamin and mineral supplement before and during pregnancy. Many pregnant women need supplements because their diets don't supply enough of the following important vitamins and minerals:
- iron—to help make extra blood for pregnancy and for the baby's supply of iron
- folic acid—to prevent birth defects in the brain and spinal cord
- calcium—to build strong bones
Folic acid is an important vitamin for you to take before and after you get pregnant to protect your baby's health. You'll need to start taking a folic acid supplement at least 1 month before you get pregnant. Most women who could become pregnant should take a multivitamin or supplement that contains at least 400 micrograms (mcg) of folic acid. Once you become pregnant, you should take at least 600 mcg of folic acid daily.
Vitamin D supplements. Studies suggest that having enough vitamin D in your blood may help maintain healthy blood glucose levels. However, more research is needed before special recommendations can be made about vitamin D levels or supplements for people with diabetes.
Current recommendations for vitamin D intake are
- for most people, including pregnant women and children at least 1 year old—600 International Units (IU) of vitamin D daily
- for babies younger than 1 year old—400 IU of
vitamin D daily
Ask your doctor whether you should take a vitamin D supplement.
Alcoholic Beverages
You should avoid drinking alcoholic beverages while you're trying to get pregnant and throughout pregnancy. When you drink, the alcohol also affects your baby. Alcohol can lead to serious, lifelong health problems for your baby.
Artificial Sweeteners
Artificial sweeteners can be used in moderate amounts. If you choose to use sweeteners, talk with your dietitian about how much to have.
You can keep track of what you eat and drink using "My Daily Food Record." Your food records can help you and your health care team see whether your diabetes care plan is working.
Read more in What I need to know about Eating and Diabetes at www.diabetes.niddk.nih.gov.
My Physical Activity Routine
Daily physical activity can help you reach your target blood glucose numbers. Being physically active can also help you reach your target blood pressure and cholesterol levels, relieve stress, improve muscle tone, strengthen your heart and bones, and keep your joints flexible.
Before getting pregnant, make physical activity a regular part of your life. Talk with your doctor about regular physical activity, such as walking, swimming, stretching, and using hand weights. Consider whether you have any health problems and which activities would be best for you. Your doctor may advise you to avoid activities that increase your risk of falling, such as downhill skiing, during pregnancy.
A sensible goal for most women is to aim for 30 minutes or more of activity a day, most days of the week. If you were active before pregnancy, you may be able to continue with a more moderate version of your usual physical activity routine during pregnancy. If you are already pregnant and haven't been active, start with an activity such as walking.
Read more in What I need to know about Physical Activity and Diabetes at www.diabetes.niddk.nih.gov.
You can keep track of your physical activity using "My Daily Physical Activity Record." Your physical activity record can help you and your health care team see whether your diabetes care plan is working.
My Medicines
Medicines for Diabetes
Some medicines are not safe during pregnancy and should be stopped before you get pregnant. Tell your doctor about all the medicines you currently take, such as those for high cholesterol and high blood pressure. Your doctor can tell you which medicines to stop taking.
During pregnancy, the safest diabetes medicine is insulin. If you're already taking insulin, you might need to change the kind, the amount, or how and when you take it. The amount of insulin you take is likely to increase as you go through pregnancy because your body becomes less able to respond to the action of insulin, a condition called insulin resistance. Your insulin needs may double or even triple as you get closer to your delivery date. Your doctor will work with you to make a personalized insulin routine.
If you've been taking medicines other than insulin to control your blood glucose levels, you'll need to stop taking them. Research studies have not yet proved that diabetes medicines other than insulin are safe for use during pregnancy.
Read more in What I need to know about Diabetes Medicines at www.diabetes.niddk.nih.gov.
Changes in My Daily Routine
Sick Days
When you're sick, your blood glucose levels can rise rapidly and diabetic ketoacidosis can occur. Talk with your health care team about what you should do if you get sick. Be sure you know
- what to do if you're nauseated or vomiting
- how often you should check your blood glucose
- how often you should check your urine or blood for ketones
- when you should call your doctor
Being Away from Home
When you're away from home—for several hours or for a longer trip—you'll want to be prepared for problems. Make sure you always have the following with you:
- a snack or a meal
- food or drinks to treat low blood glucose
- your diabetes medicines and supplies
- your blood glucose meter and supplies
- your glucagon kit
- your health care team's phone numbers for emergencies
Planning to Breastfeed My Baby
You can give your baby a healthy start by breastfeeding. Breast milk provides the best nutrition for your baby and protection against certain illnesses.
To help prepare for breastfeeding,
- talk with your health care team about your plans to breastfeed. Ask if the place where you plan to deliver your baby has the staff and setup to support successful breastfeeding.
- take a breastfeeding class. Pregnant women who learn about how to breastfeed are more likely to be successful than those who do not.
- ask your doctor to recommend a lactation consultant to help you with breastfeeding. A lactation consultant is trained to help with breastfeeding.
- talk with friends who have breastfed or consider joining a breastfeeding support group.
After Your Baby Is Born
After you have your baby, these steps can help you get off to a great start:
- Breastfeed as soon as possible after birth. The sucking instinct is very strong within the first hour of life.
- If you don't already have a lactation consultant, ask for one at the hospital to come help you.
- Ask the hospital staff not to give your baby other food or formula, unless it is medically necessary.
- Allow your baby to stay in your hospital room all day and night so that you can breastfeed often. Or, ask the nurses to bring you your baby for feedings.
- Try to avoid giving your baby any pacifiers or artificial nipples so your baby gets used to latching onto just your breast.
Many leading health organizations suggest that your baby should not have any foods or liquids other than breast milk for the first 6 months. After the first 6 months, babies can begin to eat other foods along with breast milk.
Read more in Breastfeeding and Breast Milk Overview at www.nichd.nih.gov/health/topics/breastfeeding or visit www.womenshealth.gov/breastfeeding.
Pregnancy and Diabetes: Checking Your Baby's Health
You will have tests throughout your pregnancy to check your baby's health. Your health care team can tell you which of the following tests you'll have and when you might have them. Your doctor might also suggest other tests. If certain diseases or conditions run in your family, you might meet with a genetic counselor. The counselor may recommend tests based on your family history and can explain the risk of certain conditions for your baby.
The following tests are usually done in your doctor's office or an outpatient care facility. You will be awake for all of these tests; anesthesia is not needed. For blood tests, your blood is drawn at your doctor's office or a commercial facility, and the blood sample is sent to a lab for analysis.
Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. Ultrasound is performed by a specially trained technician or health care provider. The image, called a sonogram, can show the baby's size, position, structures, and sex. The image can also help estimate age, evaluate growth, and show some types of birth defects.
First Trimester Screen
The first trimester screen is a test done when you are 11 to 14 weeks pregnant. This test involves a blood test and an ultrasound exam called nuchal translucency screening. The blood test measures the levels of certain substances in your blood. A technician will draw your blood for the test. The ultrasound measures the thickness at the back of the baby's neck.
Maternal Blood Screening Test
The maternal blood screening test is also called the multiple marker screen test, the triple screen, or quad screen. This test measures several substances in your blood. Results can tell you whether your baby is at risk for spinal cord and brain problems, Down syndrome, and other birth defects. If the results show an increased risk for problems, additional tests such as ultrasound or amniocentesis can provide more information.
Fetal Echocardiogram
The fetal echocardiogram uses ultrasound to check for problems in the baby's heart structure.
Amniocentesis uses a thin needle inserted through the abdomen into the uterus to obtain a small amount of the fluid that surrounds the baby. A specially trained technician or health care provider will perform this test.
Cells from the fluid are grown in a lab and then analyzed. Amniocentesis can help tell whether your baby has health problems and if your baby's lungs have finished developing. Mature lungs are necessary for the baby to breathe without help after delivery.
Chorionic Villus Sampling
In chorionic villus sampling, a thin needle is inserted into the placenta to obtain cells. Ultrasound is used to guide the needle into the placenta, either through the vagina and cervix or through the abdomen and uterus. The placenta is composed of tissue and blood vessels that attach the baby to the mother's uterus, so the baby can get nutrition. A specially trained technician or health care provider performs this test. Cells are then analyzed to look for health problems.
Group B Streptococcus Test
In the group B streptococcus test, a swab is used to take cells from your vagina and rectum for testing. Your doctor performs this test. The test is done at 36 to 37 weeks of pregnancy to look for bacteria that can cause pneumonia or serious infection in newborns.
Kick Counts/Fetal Movement Counting
Counting kicks and other fetal movements is an easy way to keep track of your baby's activity. You can do this test at home. You'll count how many times the baby moves during a certain period of time.
Nonstress Test
A fetal monitor checks whether your baby's heart rate increases as it should when the baby is active. Your doctor or another health care provider performs this test.
Biophysical Profile
Ultrasound checks your baby's muscle tone, breathing, and movement to obtain a biophysical profile. Ultrasound also estimates the amount of amniotic fluid surrounding the baby.
Contraction Stress Test
This test measures the baby's heart rate during contractions using a fetal monitor. Your doctor or another health care provider performs this test. The results can help your doctor decide whether the baby needs to be delivered early.
Labor and Delivery with Diabetes
Timing of Delivery
Your health care team will consider your health, your baby's health, and the state of your pregnancy in deciding how and when delivery should occur. Your doctor may recommend inducing labor before your due date or delivering the baby surgically using a cesarean section, or c-section. However, most women with diabetes have the option of delivering vaginally. You'll want to talk with your health care team about your options well ahead of time.
The factors your health care team will consider in deciding what type of delivery is best for you and your baby may include
- your baby's size and position
- your baby's lung maturity
- your baby's movements
- your baby's heart rate
- the amount of amniotic fluid
- your blood glucose and blood pressure levels
- your general health
Blood Glucose Control during Labor and Delivery
Keeping your blood glucose levels under control helps ensure your baby won't have low blood glucose right after birth. You will be physically active when you're in labor, therefore you may not need much insulin. Hospital staff will check your blood glucose levels frequently. Some women take both insulin and glucose, as well as fluids, through an intravenous (IV) line during labor. Sending insulin and glucose directly into your bloodstream through a vein provides good control of blood glucose levels. If you are using an insulin pump, you might continue to use it throughout labor.
If you are having a c-section, your blood glucose levels may increase because of the stress of surgery. Your health care team will closely monitor your blood glucose levels and will likely use an IV for insulin and glucose to keep your levels under control.
After Your Baby Arrives
You can give your baby a healthy start by breastfeeding. Breastfeeding provides the best nutrition and helps your baby stay healthy.
Your Healthy Eating Plan
If you're breastfeeding, you might need more calories each day than you needed during your pregnancy. Your dietitian can provide personalized recommendations and answer any questions you have about what, when, and how much to eat.
Your Medicines
After you've given birth, you might need less insulin than usual for several days. Breastfeeding can also lower the amount of insulin you need. Diabetes medicines other than insulin are not recommended during breastfeeding.
Low Blood Glucose
You'll be at increased risk for low blood glucose after delivery, especially if you're breastfeeding. You might need to have a snack before or after you breastfeed your baby. Your health care team may suggest that you check your blood glucose more often than usual.
Taking Care of Yourself
Remember, to be a good mom, you have to take good care of yourself. In addition to taking care of your diabetes and eating right, you can take care of yourself by taking the time for physical activity. Active moms provide a good example for their children to follow. Check with your health care team about how soon after delivery you can safely begin physical activity.
Points to Remember
- If you have diabetes, the best time to control your blood glucose, also called blood sugar, is before you get pregnant. High blood glucose levels can be harmful to your baby during the first weeks of pregnancy—even before you know you are pregnant.
- Keeping your blood glucose as close to normal as possible before and during your pregnancy is the most important thing you can do to stay healthy and have a healthy baby.
- Before you get pregnant, you can plan and prepare for having a healthy pregnancy and a healthy baby. If you have diabetes and are already pregnant, you can make sure you are doing everything you can to take care of yourself and your diabetes during your pregnancy.
- Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure you get the best care. Your health care team can help you learn how to use a healthy eating plan, physical activity, and medicines to reach your blood glucose targets before and during pregnancy.
- During pregnancy, the safest diabetes medicine is insulin. Your health care team will work with you to make a personalized insulin routine. Some medicines are not safe during pregnancy and should be stopped before you get pregnant. Your doctor can tell you which medicines to stop taking.
- You will have tests throughout your pregnancy to check your baby's health.
- You can give your baby a healthy start by breastfeeding.
Hope through Research
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts and supports research on diabetes, including type 1, type 2, and gestational diabetes. Researchers are working to find better ways to diagnose, treat, and prevent diabetes and to improve pregnancy outcomes for women with diabetes.
The NIDDK, in collaboration with the Phoenix Indian Medical Center, is conducting a study on how to best improve the health of pregnant women and their children. They will do so by providing healthy lifestyle counseling for women receiving prenatal care at the Phoenix Indian Medical Center. The women will be overweight or obese and may or may not have diabetes. More information about the Healthy Lifestyle in Pregnancy Study, funded under National Institutes of Health (NIH) clinical trial number NCT01585454, can be found at www.ClinicalTrials.gov.
The Walking Exercise and Nutrition to Reduce Diabetes Risk for You (WENDY) Study aims to find out whether giving women with gestational diabetes both a pedometer and nutrition coaching is more successful in preventing type 2 diabetes. More information about the WENDY Study, funded under NIH clinical trial number NCT01247753, can be found at www.ClinicalTrials.gov.
The Pedometers for Gestational Diabetes (PEG) Study also is looking at whether a pedometer program for women with gestational diabetes is effective in preventing type 2 diabetes after delivery. The NIDDK, in collaboration with the University of Michigan Health System, is adapting a web-based pedometer program to women with recent gestational diabetes. The program also provides educational information about exercise, diet, and nutrition. More information about the PEG Study, funded under NIH clinical trial number NCT00862602, can be found at www.ClinicalTrials.gov.
Clinical trials are research studies involving people. Clinical trials look at safe and effective new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. To learn more about clinical trials, why they matter, and how to participate, visit the NIH Clinical Research Trials and You website at www.nih.gov/health/clinicaltrials. For information about current studies, visit www.ClinicalTrials.gov.
Pronunciation Guide
amniocentesis (AM-nee-oh-sen-TEE-siss)
amputations (AM-pyoo-TAY-shuhns)
amniotic fluid (AM-nee-OT-ik) (FLOO-id)
carbohydrates (KAR-boh-HY-drayts)
cardiologists (KAR-dee-OL-oh-jists)
cardiovascular (KAR-dee-oh-VASS-kyoo-lur)
cervix (SUR-viks)
cesarean (seh-ZAY-ree-uhn)
cholesterol (koh-LESS-tur-ol)
chorionic villus (KOH-ree-ON-ik) (VIL-uhss)
conception (kon-SEP-shuhn)
depression (duh-PRESH-uhn)
diabetes (DY-uh-BEE-teez)
diabetologist (DY-uh-beh-TOL-uh-jist)
dietitian (DY-uh-TISH-uhn)
endocrinologist (EN-doh-krih-NOL-uh-jist)
fetal echocardiogram (FEE-tuhl) (EK-oh-KAR-dee-oh-GRAM)
gestational (jess-TAY-shuhn-uhl)
glucagon (GLOO-kuh-gon)
glucose (GLOO-kohss)
hyperglycemia (HY-pur-gly-SEE-mee-uh)
hypertension (HY-pur-TEN-shuhn)
hypoglycemia (HY-poh-gly-SEE-mee-uh)
insulin (IN-suh-lin)
intravenous (IN-truh-VEE-nuhss)
ketoacidosis (KEE-toh-ASS-ih-DOH-siss)
ketones (KEE-tohnz)
ketosis (kee-TOH-siss)
lactation (lak-TAY-shuhn)
miscarriage (miss-KAIR-uhj)
neonatologist (NEE-oh-nay-TOL-uh-jist)
nephrologists (neh-FROL-uh-jists)
nephropathy (neh-FROP-uh-thee)
neuropathy (noo-ROP-uh-thee)
nuchal translucency (NOO-kuhl) (trans-LOO-sen-see)
obstetrician-gynecologist (OB-stuh-TRISH-uhn) (GY-nuh-KOL-uh-jist)
ophthalmologists (AHF-thal-MOL-uh-jists)
optometrists (op-TOM-uh-trists)
pediatrician (PEE-dee-uh-TRISH-uhn)
perinatologist (PER-ih-nay-TOL-uh-jist)
placenta (pluh-SEN-tuh)
pneumonia (noo-MOH-nyuh)
preeclampsia (PREE-ee-KLAMP-see-uh)
psychologist (sy-KOL-uh-jist)
retinopathy (RET-ih-NOP-uh-thee)
sonogram (SON-oh-gram)
streptococcus (STREP-toh-KOK-uhss)
uterus (YOO-tuhr-uhss)
vaccinations (VAK-sih-NAY-shuhns)
vagina (vuh-JY-nuh)
For More Information
To find diabetes educators (nurses, dietitians, pharmacists, and other health professionals), contact
American Association of Diabetes Educators
Phone: 1–800–338–3633
Internet: www.diabeteseducator.org
Under "About Diabetes Education," click on "Find a Diabetes Educator."
To find dietitians, contact
Academy of Nutrition and Dietetics
Internet: www.eatright.org . Click on "Find a Registered Dietitian."
To get more information about taking care of diabetes, contact
American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1–800–DIABETES (1–800–342–2383)
Email: email@example.com
Internet: www.diabetes.org
26 Broadway, 14th Floor
New York, NY 10004
Phone: 1–800–533–CURE (1–800–533–2873)
Fax: 212–785–9595
Email: email@example.com
Internet: www.jdrf.org
For more information about pregnancy, contact
Eunice Kennedy Shriver National Institute of Child Health and Human Development Information Resource Center
P.O. Box 3006
Rockville, MD 20847
Phone: 1–800–370–2943
Fax: 1–866–760–5947
Email: email@example.com
Internet: www.nichd.nih.gov
Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. The original version of this booklet was reviewed by Boyd E. Metzger, M.D., Tom D. Spies Professor of Metabolism and Nutrition, Division of Endocrinology, Metabolism & Molecular Medicine, Northwestern University Feinberg School of Medicine, and Julie M. Slocum Daley, R.N., M.S., C.D.E., Women & Infants' Hospital of Rhode Island.
My Plan to Prepare for Pregnancy with Diabetes
Things I can do to get ready for a healthy pregnancy and continue to do during my pregnancy
Planning Ahead
I'll get my diabetes under control 3 to 6 months before I try to get pregnant.
I'll avoid getting pregnant before I am ready.
I'll reach a healthy weight before I get pregnant.
If I'm already pregnant, I'll see my doctor right away.
My Health Care Team
I'll make sure I have the health care team that I need.
I'll meet with members of my team regularly.
My Blood Glucose Levels
I'll set targets with my doctor for my daily blood glucose levels.
I'll set a target with my doctor for my A1C test result.
I'll learn how and when to check my blood glucose on my own.
I'll learn what to do if my blood glucose is too low.
I'll make sure my family or friends know how to give me glucagon for low blood glucose.
I'll learn what to do if my blood glucose is too high.
My Ketone Levels
I'll learn how and when to check my urine or blood for ketones.
I'll learn what to do if I have ketones in my urine or blood.
My Checkups
I'll get the recommended checkups and lab tests for
- blood pressure
- eye disease
- heart and blood vessel disease
- nervous system disease
- kidney function
- thyroid disease
- average blood glucose level—the A1C test
I'll check with my health care team to make sure my vaccines are up to date.
If I smoke, I'll quit.
I will ask for help to quit.
My Healthy Eating Plan
I'll see a dietitian or diabetes educator about what, when, and how much to eat.
I'll take a daily folic acid supplement or multivitamin with folic acid before I get pregnant to protect my baby from birth defects of the brain and spine. I'll keep taking folic acid during my pregnancy.
I'll ask whether I need other vitamin and mineral supplements and will take them as directed.
I won't drink alcoholic beverages during my pregnancy and while breastfeeding.
My Physical Activity Routine
I'll talk with my doctor about what physical activities are safe for me.
I'll make a plan with my doctor for regular physical activity and get started as soon as possible.
My Medicines
I'll talk with my doctor about my diabetes medicines—what kinds, how much, and how and when to take them.
I'll talk with my doctor about my other medicines—what to keep taking and what to stop taking.
Changes in My Daily Routine
I'll make a plan for taking care of myself when I'm sick—what to do about food, insulin, blood glucose testing, and ketone testing.
I'll make a plan for what I need to have with me when I'm away from home—for several hours or for a longer trip.
My Plan to Breastfeed My Baby
I'll plan to breastfeed my baby.
I'll talk with my health care team about my plans to breastfeed.
I'll ask which medicines are safe to keep taking while I'm breastfeeding my baby.
My Daily Blood Glucose Monitoring Times
Check off the times you should check your blood glucose levels, according to your doctor:
fasting—when I wake up, before I eat or drink
before each meal
1 hour after the start of a meal
2 hours after the start of a meal
before bedtime
in the middle of the night—for example, at 2 or 3 a.m.
My Target Blood Glucose and A1C Numbers
My Blood Glucose Targets
Write down the targets you and your doctor have chosen in the chart below. The chart includes plasma blood glucose targets for most pregnant women recommended by the American Diabetes Association.
|Target Blood Glucose Numbers (mg/dL) for Women with Diabetes Who Become Pregnant
|Before meals, at bedtime, and overnight
|60 to 99
|1 to 2 hours after eating
|100 to 129
My A1C Target
Write down your A1C target here:
My A1C target is less than _____ %.
My Plan to Check for Ketones
I should test my urine or blood for ketones
every day before breakfast
when I'm sick
when my blood glucose is _____________ or higher
other times: _________________________________
My Daily Physical Activity Record
Make a copy of this form for each week of your pregnancy. Use this form to keep track of when, what, and how long you do a physical activity.
|Week Starting:
|Type of Activity
PDF Version (52 KB) *
My Daily Blood Glucose Record
Make a copy of this form for each week of your pregnancy. Use this form to keep track of your blood glucose numbers, your urine or blood ketone test results, and your insulin.
|Urine or
PDF Version (45 KB) *
My Daily Blood Glucose Record (Continued)
Make a copy of this form for each week of your pregnancy. Use this form to keep track of your blood glucose numbers, your urine or blood ketone test results, and your insulin.
|Urine or
PDF Version (45 KB) *
My Daily Food Record
Make a copy of this form for each week of your pregnancy. Use this form to keep track of what, when, and how much you eat and drink.
Week Starting:
|Mid-morning Snack
|Mid-afternoon Snack
|Bedtime Snack
PDF Version (42 KB) *
National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20814–9692
Phone: 1–888–693–NDEP (1–888–693–6337)
Fax: 301–634–0716
Email: email@example.com
Internet: www.ndep.nih.gov
The National Diabetes Education Program is a federally funded program sponsored by the U.S. Department of Health and Human Services' National Institutes of Health and the Centers for Disease Control and Prevention and includes over 200 partners at the federal, state, and local levels, working together to reduce the morbidity and mortality associated with diabetes.
National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
Fax: 301–634–0716
Email: email@example.com
Internet: www.diabetes.niddk.nih.gov
The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1978, the Clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. The NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.
This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.
This publication may contain information about medications and, when taken as prescribed, the conditions they treat. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov. Consult your health care provider for more information.
NIH Publication No. 13–5491
August 2013
Page last updated September 10, 2014


text:
If this trade takes place the Hornets will go from, at best, a 6th seed in the west and a 1st round exit to a possible non playoff team, but one of the most exciting to watch in the NBA.
Im starting to like this trade. Im convinced that we need to start rebuilding, what better players to build around than VC and BD. In the mean time we can try to make some trades to find a servicable center and if not we will still be fun to watch.
This trade brings a bright future. Mash can be traded or bought out which leaves more cap room to sign FA. Heres a list of FA in 2005.
Then in 2006 more cap space with the contract of J.Rose expiring. Heres a list fo FA in 2006.
**Im not sure how accurate these FA listings are because in 2006 they have Mo Pete as a FA with the Hornets.

subset: commoncrawl


text:
as a side note. that kittinger fellow is a giant badass in his own right:
this man must have his pants custom tailored to fit his balls.Originally Posted by wiki project excelsior
Add me on FB and follow me on Instagram! | #TPG | #FLOSSfilthy | #V2LAB |
Always looking for cars in the NC/VA area for feature shoots! PM me!
Does anyone know if there's going to be any video coming in from Felix's side? From a helmet-cam or side mounted camera on the capsule?
I can't find anything about it
They just aborted for today...
so it goes... ಠ_ಠ
Weather tomorrow is not looking good.
yea its been canned.. lame. weird thing is website only shows 0.8mph winds...? sorry but dont think it will get much less then that.
Add me on FB and follow me on Instagram! | #TPG | #FLOSSfilthy | #V2LAB |
Always looking for cars in the NC/VA area for feature shoots! PM me!
Pretty amazing stuff but I've always wondered why they never mention that the speed of sound is different higher up in the atmosphere then at sea level. The speed of sound is about 70mph slower at 120k feet (also at ~ -30F) then at sea level (at ~ 70F). Seems that's kind of fudging the books a little bit.
Don't get me wrong. This is an amazing feet that he and Kittinger will and have done.
In one of the notes that I read it said that Felix B. has already jumped from 97,000 feet so he's been pretty close to the record already in his practice jumps.
Lately I have been testing "tip-in events". Just the tip-in. Just to see how it feels. Response time is typically on the order of 2-3 seconds. Sometimes the injection timing is a little off...
I wish them better luck with the balloon tomorrow.
That's like saying you have a 50/50 chance of getting into a car accident on the drive home, you either do or don't.
Doesn't make sense.
It's been done! So he's a few thousand feet higher and a little faster? Big deal.
Originally Posted by Mk1MadnessOriginally Posted by EistreiberOriginally Posted by Tavarish
Where can I sign up to do this? (For free. )
Algunos padres son poetas, todos los hijos son poesías. ♥
It's not the fact that he's breaking an altitude record, it's the fact that by doing that, he very well could break the sound barrier...
ban hawk..hehe
Are we sure no fighter pilot has ever ejected at supersonic speeds? I feel like someone would have somewhere in this world in the last 50 years.
Also, it's a supersonic freefall (if it happens) through basically no atmosphere vs say at like 30,000 feet. I dunno, I think it's kinda like with the X-15 goes Mach 6. It's a plane, but it's in space. Whereas when the SR-71 does Mach 3 it feels more 'real'
Anyway, I hope he has a safe fall.
member since '08 l ig:_chewwyy l flickr
For a grown ass man, you sure act like a child sometimes.
so it goes... ಠ_ಠ
You guys sure do feed the obvious troll a lot.
Scotch. It's time.
Pretty sure that Hawk has time and time again proven that he actually not a troll, but just a self righteous idiot.
so it goes... ಠ_ಠ
Last edited by absoluteczech; 10-10-2012 at 11:14 AM.
Last edited by McBanagon; 10-10-2012 at 10:41 AM.
King of the world!
It's good to hear that Felix has a great domestic supercar like the Ford GT, he didn't settle for something that a hairdresser would drive like a Cayman or Boxster.
I already mentioned it once but he has already jumped from 97k feet, just shy of the current record, he's worked his way up to this.
Lately I have been testing "tip-in events". Just the tip-in. Just to see how it feels. Response time is typically on the order of 2-3 seconds. Sometimes the injection timing is a little off...


text:
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text:
Meaghan Leddy Ph.D.
Assistant Professor of Psychiatry
Departments & Organizations
Office of Student ResearchPsychiatry
Research Interests
Serious mental illness; Psychosocial Recovery and Rehabilitation; Veteran mental health; Women's mental health
- B.A., The Johns Hopkins University, 2006
- Ph.D., American University, 2011
Selected Publications
- Leddy, M., Haaga, D., Gray, J., & Schulkin, J. (2011). Postpartum mental health screening and diagnosis by obstetrician-gynecologists. Journal of Psychosomatic Obstetrics & Gynecology, 32(1), 27-34.
- Fuller, E., Anderson, B., Leddy, M., & Schulkin, J. (2013). Obstetrician-gynecologists' knowledge, attitudes and practices regarding major depressive disorder. Journal of Psychosomatic Obstetrics & Gynecology, 34(1), 34-38.
- Kapson, H. S., Leddy, M. A., & Haaga, D. A. (2012). Specificity of Effects of Cognitive Behavior Therapy on Coping, Acceptance, and Distress Tolerance in a Randomized Controlled Trial for Smoking Cessation. Journal of Clinical Psychology, 68(12), 1231-1240.


text:
Washed Organic Linen Toddler Quilt
Loomed from pure organic linen that's been washed for extra softness, our Washed Organic Linen collection is as gentle on young skin as it is friendly to the environment.
- Tufted toddler quilt has lofty 100% polyester fill for comfort and warmth
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- Machine wash
- Made in Turkey
- In flax, grey, petal, cloud or ivory
- Due to the inherent nature of our pure, undyed natural linen in flax, subtle variations in color will occur
- Oeko-Tex® Certified
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Washed Organic Linen Toddler Quilt
Celebrate someone special. Add an initial, name or date to personalize gifts, apparel, bedding and decorative accents. Choose from our assortment of colors, fonts and styles to customize your selection with one-of-a-kind character.
- Beautifully embroidered in your choice of 22 thread colors, each with a matte finish
- Personalization is centered along one edge, approximately 6" from hem
- Size and shape of embroidery designs have been thoughtfully considered by our design team to best complement the product
- Monogrammed/Personalized items are considered custom order items and are non-cancellable, non-returnable and non-refundable
- An additional fee of $7 per item will be charged unless otherwise noted
Washed Organic Linen Toddler Quilt
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Featherblend Pillow Inserts
$16 - $34


text:
Remember you can only buy books, whose total price must not exceed 100$, you can buy one book or combination of multiple books. For sake of price you can consider prices given at amazon for Java books paperback edition, remember you need to consider price of paperback edition and not eBook. Also you are free to buy any programming or software engineering book, not just limited to Java or related technology.
Talking about myself, I would love to spend my 100$ for buying following books, Though I wanted to buy more, but I ran out of time while choosing last book, so that I can include the first two.
1) Clean Code By Robert C. Martin $37.58
5) Java Performance by Binu John $42.01
3) Just Spring Integration $17.99
Total $97.58
You can post your choice of book as comment, and I will choose best combination of books out of them, which fits on 100$ and post it here.
P.S. If you really want to play this like game, only take 10 minutes to finalize your books and try to use every cents.


text:
Academic Master Plan
Office of Dean1871 Old Main DriveShippensburg PA email@example.com(717) 477-1373College Site
214 Shippen Hall1871 Old Main DriveShippensburg, PA firstname.lastname@example.com Website
Graduate Admissions OfficeShippensburg University 1871 Old Main Drive Shippensburg PA 17257 Phone: 717-477-1213 Fax: 717-477-4016 firstname.lastname@example.com
The School of Graduate Studies Shippensburg University 1871 Old Main Drive Shippensburg, PA 17257 Phone: 717-477-1148 firstname.lastname@example.com
The Master of Education in Curriculum and Instruction is offered to fully-certified elementary and secondary school teachers. (Certification is an option in the Early Childhood Cluster only.) The 36-credit Curriculum and Instruction MEd program at Shippensburg University fosters teacher growth through exploration of principles of theory and practice that enhance teaching.
The program consists of 18 core credits that focus on four critical areas embedded in effective teaching:
The MEd in Curriculum and Instruction includes the following 18 credits of cluster choices: Early Childhood Education
Admission application reviews are June 1 (fall), September 1 (spring), February 1 (summer).
To be considered for admission, you must meet the following requirements:
Curriculum and Assessment (3 credits)
Effective Teaching and Leadership (6 credits)
The Learner (6 credits)
Focus on Research (3 credits)
Students choose clusters based on their personal goals and educational needs.
See the
Early Childhood brochure for descriptions of its three options.
Elementary Content Area Courses (9credits):
Elementary Electives (6 credits)
Required Internship
Middle School Content Area Courses (9 credits)
Middle School Electives (6 credits)
Required Internship (3 credits)
18 credits in Biology from 400- and 500-level courses, including courses offered by the Marine Science Consortium at Wallops Island. At least 12 credits must be taken in the
Biology Department. Students may structure their courses to meet individual sub-disciplinary interests.
For information, contact Dr. Tim Maret, Department of Biology, at (717) 477-1401 or
18 credits in Geography/Earth Science from 400- and 500-level courses. Three credits may be taken with advisement from Geography/Earth Science, Biology, History, Political Science, Chemistry or International Studies.
18 credits in History from 400- and 500-level courses from three categories: United States and North American History (3 credits); Global Connections (3 credits); History Electives (12 credits)
18 credits in Mathematics. Students may choose up to 6 credits from any 400-level MAT courses. They must take at least 12 credits from the 500 level.
18 credits in language and methodology from 400- to 500-level courses (at least 12 credits from the 500 level). This cluster offers an option in French or Spanish. Students must demonstrate evidence of oral and written proficiency in Spanish/French by taking the ACTFL OPI (oral proficiency interview) and the ACTFL written test. Completion of the master's will entail an oral exam and a Spanish/French Education research project.
The Ezra Lehman Memorial Library's education collection is excellent. A Curriculum Materials Center provides a wide range of teaching resources: textbooks, multimedia kits, films and filmstrips, audio and videotapes and recordings, curriculum software, etc. Computer labs are located in the library and Shippen Hall.
The Curriculum and Instruction program is delivered by a diverse faculty representing both the
College of Education and Human Services and the
College of Arts and Sciences. Faculty from the following departments will sponsor courses in this program: Educational Leadership & Special Education, Biology, Geography/Earth Science, History, Mathematics, and Teacher Education.
This page is an official publication of Shippensburg University: A member of the Pennsylvania State System of Higher Education.
Shippensburg University - 1871 Old Main Drive - Shippensburg, PA 17257 - (717) 477-7447
Ask a Question/Provide Feedback | Right-to-Know Policy | Privacy Statement | View on Mobile


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(1 of 1 customers found this review helpful)
Can't read the type
By BardTeacher
from Minneapolis, MN
About Me Quality Oriented
Comments about Personalized Rainbow Foil Pencils - Set of 12:
I purchased these personalized pencils to give to my students at the end of the year. I added a quote from a story we read. Sadly when they arrived I couldn't even read one of the words and the others were really dark. The dark purple near the top of the pencil and the black type face makes the type almost unreadable. Sadly I had to go with it because I didn't have time to return and reorder. I will not be ording these again.
Bottom LineNo, I would not recommend this to a friend
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(2 of 2 customers found this review helpful)
Color combination not good.
By Jo
from Salina, KS
Black printing on these pencils is not a good combination. I suggest you switch to white. I have some with white printing on them and they came out great. I am not happy with the results of these at all. Miles Kimball did set it up for me to get replacements. However, I would have preferred a different pencil color other than the original I ordered.
Late Del - Poor Quality Personalization
By Beth
from Rock Hill, SC
Although the website promised delivery by Christmas, I did not receive until 12/31/13. The personalization was positioned so the it was illegible. The printing was very dark and positioned on the darkest area on the pencil.
Pretty foil
By Granny
from Viola, ar
The foil is too dark and printing only comes in black. I've been a customer for years. My grandchildren love their personalized pencils, but this pencil was not a good choice. We couldn't see their names.
Not Exactly As Shown
By Jan
from Georgia
I've purchased pencils from Miles Kimball before and was very satisfied. I order them for our chorus to use in marking our music. This time I ordered the rainbow color, which is pretty, but our name was printed on them in black and nearly impossible to see. The pencils I ordered previously were printed in white. Also, the erasers are not white as shown in the picture. They are the reddish/brown color. The white is better and doesn't leave the ugly eraser marks.
Nice pencils
By Mamaloo
from Apple Valley, MN
I am happy with the quick delivery of these pencils. I gave them to my grand daughter as a gift, so I don't personally know about their use. But they looked really great, her name was spelled correctly, and she loved getting them.
Distinctive Pencils
By Arizona Annie
from Prescott, AZ
These will be perfect for my 7 year old granddaughter to use at school. Between the bright colors and the personalization, she'll never lose them.
Bottom LineYes, I would recommend this to a friend
(3 of 3 customers found this review helpful)
Kids love the colors!
By Holly595
from Wisconsin Rapids, WI
About Me Value Oriented
We personalized these for our homeschool and the kids love the vibrant colors! I do recommend you pop some novelty pencil erasers on the ends as the hard, white erasers don't work very well.
"Rainbow" pencils
By Penny the Music Teacher
from Bedford Pennsylvania
I have ordered pencils in the past. This time I feel 'ripped off'. I didn't bother to complain since the pencils were ON SALE. Now I know why. I ordered RAINBOW pencils, yet more than half came not rainbow colored, but blue and purple. I don't believe anyone did quality control checking on the lettering either, because in McIntyre's Minstrels, the 'RE' of McIntyre, and the 'EL' of Minstrels were smudge painted together.
sharp pencils
By Nana Tex
from Pearland , Tx by way of NY
Bought these pencils for our granddaughters with their names inscribed. Haven't sent them yet but they saw them on skype


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MEMPHIS, Tenn. -- The Miami University women's tennis team rounded out the fall portion of their 2013-14 schedule with a consolation final victory by junior Alix Thurman at the Memphis Invitational. Although two RedHawks competed in the championship round of their draws, neither sophomore Ana Rajkovic nor freshman Andreea Badileanu secured the victory on Sunday morning.
"We were not as consistent as we wanted to be this weekend," said Head Coach Anca Dumitrescul. "We had a solid day in singles yesterday but did not back it up against tougher competition today. It came down to executing the basics in key moments and as we prove that, results will also come.We simply need to be more commited to playing high percentage tennis day-in and day-out."
Thurman put together a 6-2, 6-1 showing over Chatanooga's Kaylene Chadwell to win the Gray Draw consolation final. Two weeks earlier, Thurman won the consolation bracket at the USTA/ITA Ohio Valley Regional, also played in Memphis.
Memphis' Marta Morga trumped Rajkovic with a 6-1, 6-1 effort in the Orange Draw final while Badileanu fell to Memphis' Liza Tymchenko by a score of 6-4, 6-2 in the Black Draw final. Sophomore Chloe Heerden, playing in the round-robin style Pink Draw, left with a second-place finish as well after downing Chatanooga's Jovana Pecovski 6-1, 6-4 on Sunday morning.
Three RedHawks lost consolation final matches on Sunday. Senior Christiana Raymond fell 7-5, 6-7 (6), 4-6 to Chatanooga's Kayla Jones in the Blue Draw. Junior Ramona Costea was beat 2-6, 4-6 by Tulsa's Carol Benito in the Black Draw. Junior Christine Guerrazzi lost 5-7, 1-6 to Marquette's Erin Gebes in the White Draw.
Miami tennis returns to action on Jan. 17, 2014 when the RedHawks travel to West Lafayette, Ind. for the Purude Invitational.


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- Oakley Red Code® drop-in deck with custom laser treatment graphic
- High-traction, high-abrasion Unobtanium® rubber outsole with Oakley icon logo
- Genuine textured leather strap with nubuck underlay
- Imported
Abrasion Resistant
Advancements in materials enhance durability to improve resistance against everyday wear-and-tear, extending longevity to ensure a full product life of dependable usage.
A treatment that allows footwear to resist the growth of bacteria, mold and mildew that cause stains, odors and product deterioration.
Red Code™
Designed to compress at progressive rates in specific zones, components made with this Oakley technology offer enhanced performance cushioning, shock attenuation and energy return.
Unobtainium Rubber outsole
Offering the traction and sure footing of surface grip, durable rubber formulations achieve performance characteristics unique to Oakley standards. They are used in our non-Vibram outsoles.


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Creamy Sweet and Salty Cashew Cream Dressing Mayonnaise or Dip
December 2, 2010
Servings:Measurements are according to your own needs.
This can be used as a mayonnaise, a base for desserts, a dressing for salads or cream dip for veggie sticks or for strawberries or other fruit..whatever you desire. It's so versatile and you can doctor it up however you like. I made this little concoction because I wanted to use up the rest of my fresh basil. It's quick and easy and the combination of sweet and salty along with its creaminess is really nice. Raw cashews are naturally sweet and so is fresh basil, but I think that soaking the cashews might bring out their sweetness even further. I didn't soak them this time and they were still sweet and blended very easily to a very creamy consistency.


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Grainger offers training, competitive salary, benefits, profit sharing trust, and an exciting work culture. Let's hit the ground running and explore all the opportunities Grainger has to offer. Come discover where you belong.
Grainger Industrial Supplier currently has the following openings in Puerto Rico. Puerto Rico jobs vary from time to time based on our current openings. Please check back often for new Puerto Rico job openings to find a career that is right for you. Thank you for considering a career in Puerto Rico at Grainger Industrial Supplier.


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Ernesto Sirolli:
Want to help someone? Shut up and listen!
When most well-intentioned aid workers hear of a problem they think they can fix, they go to work. This, Ernesto Sirolli suggests, is naïve. In this funny and impassioned talk, he proposes that the first step is to listen to the people you're trying to help, and tap into their own entrepreneurial spirit. His advice on what works will help any entrepreneur.
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This talk was presented to a local audience at TEDxEQChCh, an independent event. TED editors featured it among our selections on the home page.
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Garmin Vivofit Slate Bundle
Garmin Vivofit Slate Bundle is the ideal fitness companion reminding you when to get out of the chair and move your lazy bones with its red inactivity bar always on view. The waterproof Vivofit calculates steps, goal countdown, calculates distance travelled, calories burned and sleep quality whilst also displaying the time of day. It's also compatible with Garmin's heart rate monitor (included in this bundle)to determine your heart rate and heart rate zone. This is a great piece of kit to help you achieve your fitness goals.
Garmin Vivofit Slate BundleExtra Info
- Learns your activity level, assigns a personalised daily goal and monitors your progress
- Easy-to-read display shows steps taken, goal countdown and calories burned
- Tells the time and monitors the quality of your sleep
- VivoFit also works alongside My Fitness Pal
- Stylish, lightweight, comfortable and waterproof with 1 year plus battery life
- Wirelessly sync Vivofit with Garmin Connect™, a free on-line fitness community, to see a complete picture of your progress on your mobile or computer
- Includes heart rate monitor to record your heart rate data during fitness activities
- If using a Garmin Forerunner or Edge, you can use Vivofit to track your activity and recovery between training sessions
- Comes with large and small wrist band and USB ANT Stick™
How can I get it?
Click & Collect
Delivery available


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Every morning, hundreds of thousands of people make a pot of coffee, pour a glass of juice and fix a bowl of cereal and milk. Easy, right?
But for an increasing number of people, even one of those simple tasks is a major hurdle to undertake. For people who suffer from Alzheimer's disease or other forms of dementia, the mind is in a fog, the body doesn't seem to cooperate and it's difficult to verbalize what is wrong.
For a caretaker, of which 75 percent are family or friends of the patient with dementia, the frustrations over having to repeat oneself and worries about the patient's safety make it difficult to remain calm.
Cindy Vainright of Greenville, a caretaker of a family member who suffers from dementia, thought she understood fairly well.
But on Tuesday, she actually experienced what it's like to perform everyday tasks with the handicaps that people with dementia experience. She took part in the Virtual Dementia Tour, created by Second Wind Dreams, at the senior center.
"I just wanted to kind of see how she perceived the world," Vainright said about her mother-in-law, "and then maybe from here, I can re-evaluate her surroundings to make her life a little easier, less confusing."
People with dementia often misplace items, including their glasses. They may suffer from arthritis and diabetes, have difficulty walking and frequently drop things. Often, their brains can't filter out all the noises around them, making it easy to miss information or lose their train of thought.
Vainright's brief experience helped her feel what it might be like to suffer from dementia so she could better understand how to handle situations that come up.
"Patience is a virtue," said Mineko Holloway, the executive director of the Lenoir Council on Aging. It takes lots of patience and flexibility to be a caretaker of someone with dementia, she said.
Caretakers need to recognize their loved one may take longer to do simple tasks and may need support and their environment changed to make daily life easier, Holloway said. They may require frequent reminders and can probably only handle one task at a time.
Their behaviors include repetitive questioning, wandering, hoarding, frustration and depression leading to aggression, she said. Dealing with those behaviors is frustrating for the caregiver, as well.
"Education and proper training is the best way to prevent elder abuse," Holloway said.
January Brown, a caregiver specialist with the Eastern Carolina Council Area on Aging in New Bern, said most people who go through the virtual tour end up with a better understanding of the behaviors of their loved ones with dementia and can deal with them better.
"They need to understand," she said, "that it's not intentional behavior when they're going through Alzheimer's. It's the progression of the disease."
The patients aren't being stubborn, Brown said. Day-to-day life is difficult for them.
"When I see her getting frustrated," Vainright said, "… now I understand because so many sensory things are bombarding her. … Noise makes her forget what she was talking about."
Vainright said she will try to speak slower, give just one task at a time, redirect instead of reprimand, remain calm and offer words of praise and encouragement.
"It did make me realize some things I've been doing right," she said. "… Part of it is educating yourself about the disease."
Organizers hope to offer another Virtual Dementia Tour in Kinston before the end of the year.
Tamyra Jovel, the program services director for Alzheimer's North Carolina in Greenville, said there are lots of resources available for caregivers. For more information, call Jovel at 252-355-0054.
Margaret Fisher can be reached at 252-559-1082 or firstname.lastname@example.com. Follow her on Twitter @MargaretFishr.
For information about Alzheimer's disease or other forms of dementia, call Alzheimer's North Carolina at 252-355-0054 or visit alznc.com
What you can do for a person with dementia:
Make the environment as familiar as possible
Make visual choices available
Create calm and safety
Encourage/reassure frequently
Keep the patient busy
Take cues from them and adjust accordingly
Adjust time expectations
Source: Second Wind Dreams
Dementia Workshop
When: 9 a.m.-noon, Oct. 30
Where: Lenoir County Cooperative Extension Service, 1791 N.C. 11/55
For information, call Mineko Holloway at 252-527-1545, ext. 223
Other events leading up to National Alzheimer's Disease Awareness Month and National Caregivers Month in November:
'Energize your Caregiving' workshop, 9 a.m.-noon, Oct. 12, First Baptist Church, Farmville, preregister with SILVERcare, 252-355-5677
Candlelight Reflections ceremony, 6 p.m., Nov. 1, Greenville Town Common, Tamyra Jovel, 252-355-0054
2013 Greenville Region Walk, 9 a.m. registration, Nov. 2, Tamyra Jovel, 252-355-0054


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Results vs. Guilford (2008-03-18 15:00:00)
March 18, 2008
|Pfeiffer Defeats Guilford 8-1
|Thursday, 20 March 2008
Misenheimer, NC---On Tuesday afternoon the Pfeiffer men's tennis team played Guliford and come out with a 8-1 win. The Falcons quickly swept all three doubles to take an early lead. Pfeiffer continued their fine play and took five of six singles matches. Philip Lawson continued his strong play with a quick straight set win at #2 singles. Frank Pouchet clinched the match for the Falcons with a 6-0,6-3 win at #5.
The Falcons have a break until March 26, when they travel to their rivals Catawba College for a 3:00 pm match.


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- Current Students
- Future Students
- Florence Tour
- OSMA Scholarship
Information For:
Quick Links:
Contact Us:
CCI Kent State
Kent State University
131 Moulton Hall
P.O. Box 5190
Kent, OH 44240
SLIS at Kent State to Honor Alums at Annual EventPosted Oct. 12, 2012
The School of Library and Information Science at Kent State University will host its annual Alumni and Friends Honors and Awards Program on Tuesday, Oct. 23, beginning with a reception at 5:30 p.m. The event will be held at OCLC in the Kilgour Building, 6565 Kilgour Place, in Dublin, Ohio.
Guest speaker for this year is alumna Sue Polanka (pictured, right), head of Reference & Instruction at Wright State University Libraries. Polanka was honored recently as one of the 2011 Library Journal "Movers & Shakers" and is editor of the series "No Shelf Required."
Honorees at this year's event include the following:
Jeff Young, M.L.S. '02
OCLC Research – Software Architect
IAKM Alumnus of the Year: For a graduate who has made a significant contribution to the profession
Paige Lucas-Stannard, M.L.I.S. '04, M.S. IAKM '05
Friend of the Year: In recognition of a significant contribution to the school
Beverly Cain, M.L.S. '86
State Librarian of Ohio
August Alpers Award: For a graduate who contributed the most to the school as a student while maintaining a good grade point average
Elizabeth Owens, M.L.I.S. '11
Beta Phi Mu Student Achievement Award: For a graduate who, as a student, demonstrated the emblematic qualities of Beta Phi Mu: scholarship, leadership, and service
Shelly Miller, M.L.I.S. '11
Dan Machlachlan School Library Media Award: For a graduate who has exhibited creativity, leadership, and dedication to the K-12 audience
Karyn Lewis, M.L.I.S. '11
Jon-Erik Gilot, M.L.I.S. '11
Janice Smuda Children's Librarianship Award: For a graduate who, as a student, demonstrated creativity, leadership, and dedication to children's librarianship through outstanding academic achievement
Kathleen Rak, M.L.I.S. '11
Ruwaida Salem, UXD Certificate, '11
The Thomas J. Froehlich Award was established last year as part of the 10th anniversary of the IAKM program, in honor of IAKM founder and former program director Thomas J. Froehlich, Ph.D. It will be awarded for the first time this year.
To R.S.V.P. or for more information about the awards program, visit http://www.kent.edu/slis/alumni/index.cfm.The School of Library and Information Science (SLIS) at Kent State University has the only American Library Association-accredited Master of Library and Information Science degree program in Ohio, offering courses in Kent, Columbus (State Library of Ohio) and through a fully online option. SLIS also offers a Master of Science in Information Architecture and Knowledge Management and participates in an interdisciplinary Ph.D. in the College of Communication and Information. The school is recognized by U.S. News and World Report as one of the nation's top 20 LIS graduate programs, with a youth librarianship program that is ranked 13th. It is one of the largest library schools in the country, with more than 650 students enrolled.
Media contact:
Flo Cunningham