population health improvement plan. population health improvement plan, based on your evaluation of the best available evidence from a minimum of 3-5 current scholarly or professional sources of demographic, environmental, and epidemiological data that focuses on your diagnosis of a widespread population health issue.
Carole Lund is a 44–year–old woman of mixed Native American and European descent, and a new mother. She is concerned that she is not recovering from gestational diabetes.
Carole is here with her daughter, Kassandra, who is 10 weeks old. Carole was diagnosed with gestational diabetes at week 30 of her pregnancy. She has carefully logged her blood glucose since the diagnosis, and it shows 150–200 fasting, over 200 following meals.
Diabetes treatment received during pregnancy
Well, they gave me a glucometer, so I started using that. I could see right away that the way I was eating was a problem; I would usually work straight through the day and then have one big meal in the evening, and that was making my numbers bounce all over. So I set alarms on my laptop, so three times a day I would get interrupted, have a small meal, take a short walk, and then test my blood sugar. That helped. And then I stopped drinking juice and soda, which I should have done years ago, and that helped too. But I don’t think my numbers improved as much as my OB/GYN wanted them to, but she said my blood sugar should return to normal after delivery.
population health improvement plan
We’re you advised to take insulin during pregnancy?
She did, yeah, and we talked about it. I don’t like the idea of being dependent on a drug. I called my mother. She’s still on the reservation, so she called the elders, and we all agreed that injecting my body with an animal hormone was a bad idea. But then the doctor told me that they make synthetic insulin now, but that means it’s made in a laboratory somewhere, and I’m not sure that’s any better.
By then I was in my third trimester, and all the tests said Kassandra was big but healthy, so I thought we would just ride it out. It was supposed to clear up after she was born. But it hasn’t, and I know you have to be careful having a baby at my age. I want to do what’s best, but I don’t want to believe that insulin is my only option.
Challenges in life interfering with ability to follow treatment plan?
It’s harder now than it was before she was born. It’s just the two of us in the apartment, which is wonderful, but I don’t remember the last time I had a good night’s sleep. A lot of my work is freelance, so I make my own hours, but that also means if I’m not working I don’t get paid. I had family help while I was recovering from the C-section, and they helped cook healthy meals for me, and kept me on my schedule. Now it’s all on me — work, caring for my daughter, and managing my blood sugar. If I fall behind on anything, it will be looking after my health.