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.
Prior to her polycose her pregnancy had
Many women may be having the signs and symptoms of gestational diabetes and not know it nor know how harmful it can be to themselves or the unborn child. Some symptoms may include; blurred vision, fatigue, frequent infections, increased thirst, increased urination, nausea and vomiting, and weight loss in spite of increase appetite (Gutierrez, 2007). Having gestational diabetes can also cause harm to the unborn baby, the most common result is an increased birth weight that exceeds nine pounds (Gutierrez, 2009). In most cases not every woman that has gestational diabetes will have any of these symptoms but should be given an oral glucose tolerance test between the 24th and 28th week of pregnancy (Seibel, 2009). Almost every doctor in this day in age will have pregnant patients take this test regardless if the patient is having symptoms or not.
The tests for type 1 and type 2 are glycated hemoglobin (A1C) test, fasting blood sugar test, and oral glucose tolerance test (Mayo Clinic, n.d). Tests for gestational diabetes are initial glucose challenge test and follow-up glucose tolerance testing (Mayo Clinic, n.d).
Patients are usually given a blood test to show if diabetes is present, the test may be given because of questionable symptoms one has had or from genetic history. If after testing hemoglobin levels in your blood, and diagnosed with diabetes, insulin will then be a part of a patients’ daily routine (Insel, Deecher, & Brewer, 2012).Tests are taken to determine whether or not hyperglycemia or hypoglycemia is present. When this is discovered, the tests become more frequent. A variety of tests are done in order to keep one in good health. If diagnosed in time, and with proper care, many complications can be prevented. JDRF will be supporting
Due to the colonization and urbanization of Africa the disease began to spread quickly, inventions like the car and poor hygiene in hospitals allowed the space for the disease to become more widespread.
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
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
Type II diabetes mellitus (DM), also referred to as non-insulin dependent diabetes, is a relative, rather than absolute, deficiency of insulin (ADA, 2004). It is global problem and has been identified as one of the “most challenging contemporary threats to public health” (Schauer et al., 2012). One is at risk for developing type II diabetes if they are overweight, over the age of 45, have a relative with type II diabetes, are sedentary, gave birth to a baby over 9 pounds, or had gestational diabetes (Center for Disease Control and Prevention [CDC], 2016).
Assessing the target population by detecting glucose abnormalities by measuring HbA1c can significantly benefit individuals from primary prevention through risk factor modification and may impact those undiagnosed and facilitate introduction of diabetes prevention at a public level.. Due to socioeconomic disadvantages and lack of access to care, vulnerable populations such as minorities are more likely to develop diabetes. Thus, interventions which prevent the development of the disease and ensure adequate and appropriate management must be implemented to reduce the burden of T2D. Diabetes education, self-management education, and adequate access to health care are considered key factors to achieving
National Institute for health and Care Institute 2005, advise women with a fasting plasma glucose level between 6.0 and 6.9 mmol/litre that they are at high risk of developing type 2 diabetes, and offer them advice, guidance
Case study: Carol is 17 years old and was diagnosed with Type 1 diabetes at the age of 7 years. Carol has had a recent hospital admission for dehydration and high blood glucose. During the admission Carol was found to be 6 weeks pregnant. Prior to the admission she had been experiencing weight loss and changes in mood.
Afton is a 31yo, primigravida, who is currently 23 weeks 6 days. She has type 2 diabetes but her A1C coming into pregnancy was just under 6. A recent A1C in June was 6.1. She is currently on insulin with Levemir and NovoLog. She also has chronic HTN and takes labetalol. She is on a baby aspirin for preeclampsia prevention. She has been following in our perinatal diabetes program and we have made some adjustments. Because of her type 2 diabetes she is here today for a fetal ECHO.
There are several different types of diabetes. Type one diabetes is when the body produces little or no insulin and can be known as a chronic disease. This type can be considered the most severe, because people who have type one are born with it and there is no cure. The only way to control type one is to manually pump insulin into the body whenever sugar is consumed. Gestational diabetes occurs only in pregnant women and is caused when the body changes and cannot respond to insulin (National Institutes of Health). In many cases this type of diabetes can be set in remission with the correct diet and exercise during a pregnancy. This type also has the chance to give the unborn child diabetes as well, and the mother may have to live
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
JB was terrified during the interview because she also had a history of gestation diabetes with her last son and was not eating as nutritionous as she wanted to and did not exercise regularly despite having available resources. This author can understand her fear for developing diabetes as the literature indicates that it is the sixth leading cause of death and is cited as a global epidemic (Castro et al. 2008). The author also understand her risk for developing type 2 diabetes, like many of her maternal relatives, because it is closely linked to obesity and sedentary lifestyle which are factors the patient has at this time (Shulze & Hu 2005). This author will not just solely focus on her risk factors but on promoting her prevention of diabetes and well being in the future through the development of a
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.