Treatment Of Gestational Diabetes Mellitus

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.

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.

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

Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while

Methods: The methods used in this article was a double-blind, placebo-controlled trial. From a group of 450 pregnant women without diabetes and with a BMI greater than 35, half of the group was randomly given a dose of 3.0 g of metformin per day, and the other half was randomly given a placebo per day. The metformin and placebo were given from 12 to 18 weeks gestation with a singleton fetus until the delivery. At the start of the study at 12 or 18 weeks of gestation, the BMI of each participant was measured by dividing the weight in kilograms by the square of the height in meters, BMI = weight (kg)/ height2 (m2). Randomization was achieved by using a computer to generate random numbers.

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:

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.

It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection

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

As the years go by, society starts to progress and develop many fast and easy solutions for everything. Not only are the easy solutions being created but the cost of living is increasing making people to work harder and later and not have time to have a healthy lifestyle. Fast foods are everywhere you go and not only is it fast it is also cheap making it harder to get a decent healthy meal. Due to society changing so much, diabetes is on the rise. What is diabetes? Diabetes is several diseases that are characterized by high levels of glucose that are the results of the insulin action or production. “The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both.” (CDC) If diabetes is not taken seriously, it can have severe damages that include organ failures or damages and even death.

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

Gestational diabetes, affecting approximately 3-10% of pregnancies, is diagnosed by hyperglycemia during pregnancy in women without a history of diabetes. The underlying cause of gestational diabetes remains unknown, although the interference of pregnancy hormones, such as human placental lactogen, with susceptible insulin receptors, has been considered. The patients usually have few symptoms, and they are often diagnosed by screening during routine pregnancy check-up. For the mother, glucose intolerance typically disappears after the baby is born. However, gestational diabetes often places the body at risk. Babies born to mothers with poor hyperglycemia control are often at increased risk of series problems including macrosomia, which associates with a high chance of C-section, shoulder dystocia, hypoglycemia after birth, polycythemia as well as multiple chemical disorders.

Gestational diabetes, which is much less common, only occurs during pregnancy and is caused by a resistance to the actions of insulin brought on by the hormones a woman’s body releases during pregnancy (WHO 2011, p. 2). Once diagnosed with gestational diabetes mellitus you are at a greater risk of developing type 2 diabetes later in life (Zimmet & Magliano 2011). For this reason it is particularly important to use preventative measures and consistent health checks.

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