Gestational Diabetes and Antenatal Education of Women with Gestational Diabetes
It is estimated that 1-14% of pregnant women will develop gestational diabetes mellitus(GDM) (Hieronymus, Combs, Coleman, Ashford, & Wiggins, 2016). GDM is carbohydrate intolerance developed during pregnancy and is the most common metabolic complication of pregnancy (Wilson, Dyer, Latendresse, Wong, & Baksh, 2015). Gestational diabetes has been known to have serious complications for both the mother and the infant (Gilbert, 2011). Management of GDM includes diet, exercise, education, and possibly insulin therapy (Kopec, Ogonowski, Rahman, & Miazgowski, 2015).
Pregnancy is a challenging time for a woman, and receiving a GDM diagnosis makes this time even more stressful. Furthermore, GDM rates in the developed world are undergoing a substantial increase as a result of increased obesity, maternal age, and migration of women from areas with a high risk of GDM (Carolan, 2013). In light of this, the role of the perinatal nurse is becoming increasingly important. An informed, caring and capable perinatal nurse is an essential part of a care plan that helps a woman with GDM deal with the constant tests, dietary restrictions, regular glucose monitoring, possible insulin injections, and all the other stresses that go along with this complication to her pregnancy.
This paper will focus on gestational diabetes. I will discuss its incidence, risk factors, diagnosis, signs and symptoms, maternal and fetal
Along with all the worries and complications a woman might face while pregnant, one of the more serious conditions is gestational diabetes. Gestational diabetes occurs in 4% of all pregnancies (Seibel, 2009). Many women are not informed about the disease, some may not know that they need to be tested, and others may have heard about it, but want more information on what may cause it and/or how to prevent and treat it. Either way this disease needs to be taken seriously by every pregnant woman or woman planning to get pregnant to protect not only herself but the unborn child.
Most pregnancies progress with the mother being healthy, however in some cases problems do arise with the mother developing complications. This can in the form of gestational diabetes. Mothers who didn’t have diabetes prior to pregnancy exhibit high blood sugar levels, in most cases this is during the later stages of pregnancy, this could lead to pre-eclampsia and babies could be born with higher birth weights. If left unchecked mothers can develop type 2 diabetes post pregnancy.
Amanda manages her gestational diabetes with diet. She experiences a few episodes of postprandial hyperglycemia, but does not have to go on insulin. At her 36-week
Unlike type 1 and 2 diabetes, gestational diabetes isn’t permanent. It affects women when they are pregnant and usually ends after the baby is delivered (1, 8). The main causes of gestational diabetes are damage to insulin producing cells, resistance to insulin and genetic heredity. Also, it is believed that women that get gestational diabetes will have a higher risk of developing type 2 diabetes (1, 8).
4). There are two major types of diabetes mellitus, type 1 and type 2, and gestational diabetes is a third type that could occur during pregnancy. Type 2 diabetes mellitus is the more common of the three types, attributing tor around 95 percent of new cases of diabetes (Prezbindowski & Porth, 2005 pg. 1309 para. 1). Diabetes mellitus is caused by one’s body having trouble breaking down foods they eat to convert to energy due to an inefficient supply of insulin or an inability to use insulin effectively. The source of the problem derives from beta cells located in the pancreas. These cells are special for their production of insulin and response to it. If there is a problem with the beta cells in the pancreas, then their inefficient supply and absorption of insulin results to an increased amount of glucose in the blood stream that cannot be absorbed sufficiently which leads to a diabetic condition. If one may suspect diabetes mellitus as a health condition they are experiencing, there are common signs and symptoms that are associated with the disease.
The Gestational Diabetes Act is a bill that amends the Public Health Service Act (Congress.gov., 2015). This act emphasizes on the National Vital Statistics System, the National Center for Health Statistics, and State health departments to monitor and collect data on GDM. Regarding babies born from mothers with GDM, those diagnosed and undiagnosed with GDM. Finding ways to track and monitor postpartum women with GDM, implementing interventions that are culturally sensitive to reduce the risk of developing GDM and complications. The act also focuses on clinical and public health research on GDM to find interventions for women with a history of GDM from developing DM II as well as their children. Research on understanding GDM regarding risk
Women with GDM are at elevated risk for numerous maternal health complications, and their infants are at elevated risk for death and morbidity. (Dye, Knox, Artal, Aubry, & Wojtowycz, 1997)It developed in one out of twenty five pregnancies worldwide. Frequently it occurs in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. It usually disappears after pregnancy, but the mother and the child are at big risk of developing type two diabetes.
In gestational diabetes, this type of diabetes develops in women only during pregnancy. When a woman is pregnant there are a surge of varied hormones that are produced. These hormones sometimes lead to a pregnant woman developing resistance to the insulin just like the other two types of diabetes. It also comes about because the body cannot use the insulin that is produced, effectively. This usually affects a woman in her second trimester and goes away after the birth of the baby. Developing GD can put a woman at risk of developing type 2 diabetes later in her life or developing GD with every pregnancy that follows. It can also lead to certain health problems in their children like childhood obesity or the risk of developing diabetes in later life.
RESEARCH ARTICLE: Rowan J., Gao W., Battin M., & Moore M. (2008). Metformin Vs. Insulin for the Treatment of Gestational Diabetes. The New England Journal of Medicine. 358(19):2003-2015.
My peice of advice as well was to seek a doctor. Being healthy prior to conceiving is very helpful when it comes to Gestational Diabetes. I was very fortunate with both of my kids that i didn't get Gestational Diabetes. I was 17 when i had my first child and very active. If i was not doing traveling softball on the weekend then i was cheering on a competition cheer squad. I agree on the overall lack of care. It drives me crazy to see some of the things that parents let there kids eat. My sister in law is a good example of that. She uses they excuse that they are growing boys and they are going through that stage. I just want to shake her and say portion control and eat heathier. She suffers from morbid obesity and her kids are 11 and 17, they
Gestational diabetes is a disease that affects pregnant women it’s a glucose intolerance that is started or diagnosed during pregnancy. Based on recently announced diagnostic criteria for gestational diabetes, according to the American Diabetes Association, it is estimated that gestational diabetes affects 18% of pregnancies. Pregnancy hormones can block insulin therefore causing the glucose levels to increase in a pregnant woman’s blood. Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy (American Diabetes Association). Without enough insulin, glucose cannot leave the blood and be changed to
Kansas City is a very diverse place where there are many cultures who live in the melting pot of the city. With different cultures comes different lifestyles that affects a person’s overall health. It so happens to be that obesity, unhealthy eating, and not enough physical exercise has led to a substantial increase in diabetes, making it the number seventh leading cause of death (American Diabetes Association, 2014, p. Diabetes Basics). Diabetes also called diabetes mellitus is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood (Google, What is Diabetes). There is three type of diabetes, Type 1, Type 2 and gestational diabetes. Type 1 is mostly seen in juvenile, where they become insulin dependent because the body immune system attacks the pancreas (Diabetes Research Institute, 2014, p. What is Type 1 Diabetes?). Type 2, which account for 90% of cases is seen in those who are obese, who have a family history, who are older and have unhealthy eating lifestyles, is when the body doesn 't know how to use the energy efficiently to process sugar Google, What is Diabetes; Center for Disease Control, p.2). Gestational diabetes happens during pregnancy when there is higher levels of sugar and normally goes away afterwards. (Center for Disease Control and Prevention, p.2). We will briefly explore the epidemiology surrounding diabetes, how it’s impacting the metro area as well as its effects on the body.
Gestational diabetes mellitus (GDM) is an intolerance of glucose documented for the first time during pregnancy. It is usually a short-term type of diabetes and the most common health problem with pregnant women. GBM is caused by the way the hormones in pregnancy affect the mother. GDM accounts for 5-7% of all pregnancies (American Diabetes Association, 2010). During pregnancy the placenta develops and becomes the main bond between the mother and the baby. It is used to make sure the baby has and gets enough nutrients. The placenta makes several hormones which make it hard for insulin to control blood glucose and block the action of the mother’s insulin in her body (American Diabetes Association, 2010). Hormonal changes during the
According to the American Diabetes Association, the prevalence of gestational diabetes is as high as 9.2% in pregnant women due to obesity or being overweight. Not only can it be harmful to the mother, but it can also be harmful to her baby. Gestational diabetes can increase the chances of pregnant women delivering a baby that weighs more than 9 pounds. Having gestational diabetes can also increase the mother’s chance for needing a cesarean section delivery. Some other risk factors that the mother can be a candidate for developing gestational diabetes by is having a family history of diabetes (especially if a parent or sibling has diabetes) and having gestational diabetes in previous pregnancies. Pregnant women don’t need to have had diabetes before in order to develop gestational diabetes. They can just have high blood glucose levels during pregnancy to get gestational diabetes. There is a process in which the baby has to go through inside their mother’s womb. The placenta is what supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother 's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother 's body to use insulin. She may need up to three times as much insulin. Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose
Treatment of gestational diabetes mellitus, whether using insulin, oral diabetes medications, or another means, reduced maternal, fetal, and neonatal risks associated with the disease. When treating GDM, the goal is to bring the patient’s blood glucose levels down to the same levels as those of pregnant women without GDM. Current therapeutic targets are: fasting blood glucose ≤95 mg/dL, 1-hour postprandial <140 mg/dL, and <120 mg/dL for 2-hour postprandial blood glucose concentrations (Hernandez, et al., 2011). However, just as there is no universal agreement on screening and diagnosis strategies, there is no universal agreement on the optimal therapeutic targets in the treatment of GDM. Blood glucose concentrations during a normal pregnancy are actually lower than these targets, and in fact, rarely exceed 100 mg/dL in the absence of obesity. Hernandez, et al. (2011) recommended lowering therapeutic targets to levels more in line with normal pregnancies. They found that mean blood glucose concentrations in 255 pregnant women of normal weight without GDM were 71 mg/dL (fasting), 109 mg/dL (1-hr), and 99 mg/dL (2-hr). Given the fact that adverse outcomes are directly linked to blood glucose concentrations, it is appealing to aim for lower levels; however, this goal must be balanced with the possibility of inducing hypoglycemia in patients with treatment.