Risk Factors For Gestational Diabetes Mellitus

Even though it has long been known that women with preexisting type 1 and type 2 diabetes are at increased risk for adverse maternal and fetal outcomes, the relationship of GDM to various perinatal risks has been less clear. O'Sullivan and Mahan3 developed, Glucose tolerance test criteria for the diagnosis of GDM, nearly 50 years ago. It has been

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

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.

Caring for yourself during your pregnancy when you have type 1 or type 2 diabetes (diabetes mellitus) means keeping your blood sugar (glucose) under control with a balance of:

The research article has very detailed information on the research, while the general article has only superficial information. The research article has clear information about the test subjects, their age range, the duration of experiment and its effects. On the other hand, the general article does not even specify the information about the target subjects, their gender, age range and time duration.

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

The article titled “Follow-Up of Gestational Diabetes Mellitus in an Urban Safety Net Hospital: Missed Opportunities to Launch Preventive Care for Women” is a qualitative study from the Journal of Women’s Health. This study aimed at assessing follow-up care of patients with GDM in the postpartum period amongst a group of women with racial and ethnic

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.

A study done by the Health Care Agency found that the most common prenatal complication in women that lived in Orange County was gestational diabetes. The stated target population is women that live in Orange County, specifically in Santa Ana. The prevalence of gestational diabetes in Orange County was 7.1% affecting nearly 3,000 women in 2009 (Ramos et al., 2011, 2). This data shows the prevalence rates according to each city in Orange County Santa Ana as well as Anaheim, Garden Grove, and Irvine made up almost half of the gestational diabetes cases in 2010 (Refowitz, 2012, 8). Looking at Santa Ana specifically, the prevalence of gestational diabetes was 7.06% with a total of 438 cases in 2010 with a total of 6,202. The stated target

After reviewing the study and learning more about gestational diabetes, I feel that with more education and ensuring compliance in nutrition, testing, and follow up are beneficial to the pregnancy and after pregnancy as well. The importance of education, and compliance, however, is not only exclusive to gestational diabetic pregnancies. All pregnancies could benefit from increased education of nutrition, and importance of compliance with follow ups and testing. The challenge with the study was the loss of sample size, which is not just a problem for the study, but an issue felt by obstetricians, family physicians, and other pregnancy specialists; loss of sample size for the study is equal to lack of compliance of prenatal care in the office. Encouragement and more frequent checks on good prenatal care would benefit not just gestational diabetes

I cared for a pregnant patient who had gestational diabetes. She brought in her blood sugar logs and according to her logs, her sugars were not well controlled. The patient was also a vegetarian due to her religion. We ordered a dietitian to come and educate the patient on healthy meal options that will prevent blood sugar spikes and promote a healthy pregnancy and still meet her religious restrictions.

According to American Diabetes Association (2004), GDM is usually diagnosed between 24 and 28 weeks (p. S88). GDM affects approximately seven percent of all pregnancies (p. S88). If GDM is left untreated, it can cause adverse effect on the mother and the child. American Diabetes Association (2004) also illustrated that maternal and perinatal morbidities are linked to the untreated GDM (p. S88). Although gestational diabetes disappears after birth, women with GDM are at increased risk for developing diabetes later in life. As mentioned by National Institutes of Health (NIH) (2006), babies of untreated mothers with GDM can suffer from macrosomia, hypoglycemia, jaundice, respiratory distress syndrome and low

The hormonal changes that occur during pregnancy lead to hyperinsulinemia and insulin resistance, which causes some women to develop diabetes when their pancreatic function is not sufficient. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset of pregnancy. The prevalence of gestational diabetes in the United States is between 1.5% to 15%. GDM tends to occur more frequently inAfrican American and Hispanic women . GDM is the most common co-morbidity during pregnancy and its prevalence is on the rise likely due to a parallel increase in obesity. Women diagnosed with GDM are at increased risk for obstetric complications, and higher higher rates of fetal morbidity and mortality.

There are numerous causes that can provoke the gestational diabetes in pregnancy women. “Some strands of scientific opinion suggest a possible role for epigenetic factors in the complex interplay between genes and the environment that are related to insulin resistance, T2D, and GDM

According to Blake (2011) glucose screening is recommended for women at high risk (including the risk factors mentioned above) for gestational diabetes, but is not recommended for certain women; women who are: under the age of 25, no first degree familial diabetes, normal pre-pregnancy weight and healthy pregnancy weight gain, no history of glucose intolerance, and no previously poor outcomes obstetrically. In comparison, the American College of Obstetricians and Gynecologists (ACOG) endorses universal screening of all pregnant women for gestational diabetes mellitus (GDM) (Coustan 2013). The usual screening test used for GDM is a 50-gram 1-hour glucose challenge (50-gram oral glucose test) at 24-28 weeks gestation (Coustan 2013; Brown, 2011). This one hour glucose test is used as the initial screening tool to identify potential cases that may need further testing; further testing is required if the glucose level is greater than or equal to 130 mg/dL (Brown, 2011). The first test is followed up with either the 100-g/3-h oral glucose tolerance test (OGTT) or the 75-g/2-h OGTT; the OGTT is usually performed by giving a pregnant woman a drink containing