Randomized Trial Of Metformin Vs Insulin

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.

Offer lifestyle advice and check a FBG at 6-13 weeks after birth in those women with GDM. Do not routinely offer an oral glucose tolerance testo

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

Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. Retrieved from: http://www.nejm.org/doi/full/10.1056/nejmoa012512

How can one effectively manage type 2 diabetes during pregnancy? If you are planning to become pregnant and diabetic it’s advisable to visit a doctor to prescribe Metformin to achieve normal blood sugar levels for six months before getting pregnant and to maintain the levels for the nine months of the pregnancy. If you have been keen on keeping diabetes under control, continue with the routine since there will be two on board. For an individual to enjoy benefits brought by Metformin, diet and exercise are vital.

There is an unresolved debate on whether routine HbA1c’s are not cost effective and the model should remain as women receiving a polycose test at 24-28 weeks. An HbA1c is a blood test that requires no consumption of concentrated glucose drinks or fasting. It measures the amount of blood glucose over the prior 120 days (Sevket, Sevket, Ozel, Dansuk & Kelekci, 2014). It has however been concluded that HbA1c’s are not an alternative for diagnosis of GDM and are not useful in reduces the need for further diagnostic testing (Sevket, Sevket, Ozel, Dansuk & Kelekci, 2014). Therefore not all guidelines are updated to follow these recommendations supported by the MOH (2014) REFERENCE and REFERENCE. The algothrithm for ADHB (2013) and WDHB (2012) follow the ‘risk screening’ approach where only women with risk factors are offered an HbA1c, all other women are offered the routine polycose at 24-28 weeks. Victorias midwife followed these guidelines. The screening and diagnosis of GDM also detects unrecognised type two diabetes and rarely type one (Pairman et al., 2015) because the pathophysiology of type 2 diabetes mellitus includes insulin resistance, similar to GDM. Thus pregnancy provides a window of opportunity to identify women at risk of developing type 2 diabetes or who may be in the prediabetic state (Lacroix et al, 2013; Chasam-Taber, 2015). Prehaps if Victoria was offered an HbA1c at booking her GDM might have been recognised earlier.

It is defined as an increase in blood glucose levels diagnosed during the pregnancy and induced by the pregnancy. The hormones secreted by the placenta lead to the development of an insulin resistant state which is more pronounced during the last three months of the pregnancy. If uncontrolled, it can lead to abnormalities and complications in both the mother and the baby. It can lead to malformation of the heart/kidneys of the baby, low birth weight or even a large baby

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.

All of her glucoses were reviewed and all of them fell within normal range. Because she is on metformin, we would recommend twice weekly antenatal testing. She has an appointment in your office in 3 days at which time a NST can be performed

Diabetes has been established to be more precarious for women, as it can augment pregnancy complications such as macrosomia, miscarriage, and birth defects. Women with diabetes also have a higher prevalence of secondary cardiovascular disease. Among those women who continue in the spiral of diabetes complications, ischemic heart disease is an even greater complication which will reduce survival and quality of life (Beckles and Thompson-Reid, 2011). Pregnant women diagnosed with gestational diabetes mellitus (GDM) have a higher risk of developing type 2 diabetes later in their lifetime. It has been proven that an average of 25 percent of pregnant women with GDM will be diagnosed with type 2 diabetes within an average of seven years (Sokup, Ruszkowska-Ciatec, Walentowicz, Grabiec & Rose, 2014). In such women, blood glucose and triglyceride levels must be monitored closely, and appropriate action and referrals are given if needed for proper disease management.

There are two types of diabetes that occur not due to pregnancy: Type 1 and Type 2. Type 1, also known as “insulin dependent” and “juvenile” diabetes occurs because of a genetic hiccup in which the pancreas’ beta cells can’t properly create and distribute insulin, causing the individual to have to take injections. The second type of diabetes, Type 2, occurs when the body can’t make enough insulin for adequate function of the body, albeit from age or weight. In this type of diabetes insulin injections are less common (although can still be prescribed depending), which is why the main focus and recommendations will be based on Type 1 diabetic mothers.

Offer lifestyle advice and check a FBG at 6-13 weeks after birth in those women with GDM. Do not routinely offer an oral glucose tolerance test

Between 5.5 and 8.8% of pregnant women develop GDM in Australia. Risk factors for GDM include a family history of diabetes, increasing maternal age, obesity and being a member of a community or ethnic group with a high risk of developing type 2 diabetes. While the carbohydrate intolerance usually returns to normal after the birth, the mother has a significant risk of developing permanent diabetes while the baby is more likely to develop obesity and impaired glucose tolerance and/or diabetes later in life. Self-care and dietary changes are essential in treatment.

Gestational diabetes is usually diagnosed during the pregnancy of a woman. The affected women have high levels of blood glucose which cannot be compensated by insulin from the body resulting in increased levels of glucose. Reworded from the MediLexicon source, around ten to twenty percent of affected women need to take regulating medication in order to prevent complications at their child’s birth. Complications can happen if the diabetes is not properly treated in time. Pregnant women are at most risk of Gestational diabetes if they were on a high animal fat or cholesterol diet. Although it may not get as much attention as the other two types of diabetes, Gestational diabetes is caused by similar circumstances to those that cause type 1 and type 2 (MediLexicon International).

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