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Celebrate mom with good health: 6 tips to help mothers prevent diabetes
Caring for Mom: A Unique Kind of Patient
As a family physician, Dr. Kirley has cared for mothers from diverse family settings -- single mothers, women with several children or even nurturers who care for an elderly parent. While each of her patients grapple with their own barriers and lifestyle factors, when caring for mothers, one prevailing trend usually emerges: "Mothers are under tremendous time pressure and have a tendency to prioritize everyone over themselves," Dr. Kirley said.
During appointments, she'd often see women who had delayed addressing their own medical issues to care for a child's ailments, lead busy households, or juggle countless responsibilities. Moms swirling in a vortex of demands also present a unique challenge for physicians.
"Because they put caring for so many people above caring for themselves, oftentimes, we'd have to play catch up [with managing their own health]," Dr. Kirley said. "We'd have to catch up on controlling their blood pressure or catching their diabetes instead of preventing their diabetes."
Unlike the average single patient, mothers are deeply connected to a network of daily stressors, which impact their health and the health of others around them. That's why Dr. Kirley encourages physicians to build effective relationships with mothers by strengthening partnerships with their children, spouses and families.
How to Help Mothers Prevent Diabetes, Improve Health Outcomes
To help mothers avoid chronic disease and live a healthy lifestyle, she recommends physicians try these six clinical tips:
- Ask the right questions about her family dynamic and support system. Before prescribing a care plan, Dr. Kirley always asks mothers about their entire family system to ensure any recommendation she makes actually aligns with her patient's reality -- not simply a template prescription.
"One of the great things about being a family physician is that I was usually not just taking care of mom," Dr. Kirley said. "I was also caring for kids, spouses, and sometimes extended family members, so I had many chances to think about the family dynamic and extended family that could support mom in making healthy changes."
In early conversations with mothers, she recommends physicians consider key questions, such as:
- What's her family support system like?
- What are her feelings of self-efficacy?
- What goals does she feel too busy to accomplish?
- Are there any people in her life who may be effective allies?
"Think about the way you communicate," Dr. Kirley said. "So that instead of walking into a situation and being prescriptive, you're actually having a conversation to understand your patient's [health], what they're dealing with, their barriers and abilities to manage their own conditions."
- Remind mothers of their power and influence. While it may be tempting to simply urge mothers to "put their health first," Dr. Kirley suggests a different approach.
"Many mothers are actually proud of their ability to take care of others," she said. "So it's helpful to frame your advice or interactions with patients [by reminding them] that taking care of themselves empowers them to take care of their family members."
If a mother is deeply connected to her relatives, shape this connection into motivation for her to improve her health.
- Set small goals and give her a chance to suggest ways to accomplish them. In practice, Dr. Kirley found that her patients were often the best partners to consult when creating an effective care plan.
To encourage lasting behavioral changes, she recommends physicians help mothers identify concrete goals that align with people or things they find meaningful. Then, give them a chance to outline baby steps to accomplish these goals.
"Usually when you spend more time listening to your patient, the patient will figure out a plan for themselves," Dr. Kirley said. "As a physician, you don't have to be prescriptive. Most of the time when I give my patients the chance to talk through their [day], they think of examples of small changes -- like taking a 10 minute walk with their kids or adding one more vegetable to each meal -- on their own."
As you work with her to set goals, let her know that she doesn't need to work alone to accomplish her health goals. For example, if she has prediabetes you can refer her to a CDC-recognized lifestyle change program, which will offer education and group support as she seeks to make healthy changes to prevent the onset of type 2 diabetes.
- Suggest turning "down time" into quality time with the kids. This is especially helpful for patients who are single mothers because they routinely lament not having enough "quality time" with their children, Dr. Kirley said.
This is why she encourages mothers to replace passive down-time -- moments spent scrolling phones or watching television -- with healthy activities that support family-bonding.
For instance, "One of my most successful moms, in terms of losing weight and changing her lifestyle, really roped her whole family into helping her cook healthy meals," Dr. Kirley said. While her husband was away serving in Afghanistan, her patient began delegating meal prep responsibilities to her children, which has made a profound difference in her health while setting a positive example for her family.
- Educate expecting mothers on gestational diabetes. Many of the same women who are at-risk for developing type 2 diabetes are also at risk for developing diabetes during pregnancy. Yet, "Pregnancy is a super interesting time [for patients] because women tend to be really engaged with making healthy choices," Dr. Kirley said. "It's a great time to intervene and encourage behavioral changes."
Ideally, physicians who care for women of reproductive age should help mothers lower their weight and make healthy choices before they become pregnant; however, if a woman is pregnant, it's important for physicians to dispel one common medical myth: "For a long time, there was a lot of debate among physicians about whether or not exercise was safe during pregnancy," Dr. Kirley said. "The prevailing thinking used to be that if a woman didn't exercise before she got pregnant, then she shouldn't start. There's this concept that pregnant women just need to 'take it easy' when in reality, that's actually not true."
In fact, women who are overweight and obese should engage in mild to moderate activity even while they're pregnant, Dr. Kirley added, noting that an active lifestyle and healthy weight are essential to preventing gestational diabetes.
- Try games and apps. Although every family isn't tech-savvy, if you do work with mothers who embrace technology, use this interest to share motivating data about their health and progress. "Some people are motivated by feedback and seeing changes over time," Dr. Kirley said. "Other patients are motivated by competition, so apps like MyFitness pal where you can add friends and compete for health goals, can really help. It's all about what motivates the patient."
Research has also shown that gamification can prompt patients to take steps toward a healthier lifestyle. "Pokémon Go was hilarious but it got so many people up and moving," Dr. Kirley said, noting that the Pikachu-paved game surprised many patients and her colleagues. "It just shows how far people are willing to walk for something they enjoy."
Want more tips and tools to help mothers prevent diabetes?
- Download this comprehensive toolkit from Prevent Diabetes STAT , which features key resources -- including handouts, questionnaires, sample referral forms, and step-by-step guidelines -- on prediabetes screening and diabetes prevention.
- Use doihaveprediabetes.org for patient-facing resources that mothers can use to raise awareness about diabetes prevention among their family and friends.
- Bending the diabetes curve in Michigan, this webinar will review the evidence base for clinical approaches to diabetes prevention, and describe how physicians and care teams can implement a diabetes prevention initiative within their practice.