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gestational diabetes mellitus research paper
literature review gestational diabetes
literature review gestational diabetes
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The prevalence of Gestational Diabetes mellitus (GDM) is growing worldwide. 1-14% of women in pregnancy is affected by DM 1. Due to increased incidence and proposed lower¬ing of the thresholds for diagnosis the health care cost of GDM can be expected to rise proportionately. The discussion of whether a benefit exists to the treatment of GDM assumes greater importance now than in the past. 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 known that, if optimal care is not provided, women with GDM and elevated fast¬ing glucose levels appear to be at risk for fetal overgrowth and perinatal morbidity.4 For several decades whether a significant association of milder forms of carbohydrate intolerance exists with macrosomia and adverse perinatal outcomes has been questioned and debated.5 Older studies, focusing on this issue interpreted that confounding variables including parity and maternal obesity may not have been considered in the analyses or that treatment was in fact applied to the population described.6 . Therefore, the effect of glycemia on various outcomes may have been incorrectly estimated. The recent Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study has settled much of the debate about the relationship of various degrees of maternal glycemia to specific pregnancy outcomes.7 In this large-scale international study, women with fasting glucose up to 105 mg/dL, were enrolled. The researchers described the continuo... ... middle of paper ... ...at new diagnostic thresholds based on relative risk must be adopted by expert consensus. Frequency of LGA infants and primary cesarean rates as seen in HAPO study is given in table 2. Evidence of any benefit to the treatment of glucose levels lower than the current criteria for diagnosis are lacking. Studies seen above provide evidence that treatment of even mild GDM with dietary intervention and insulin as necessary is effective. The need to establish such clinical evidence cannot be ignored because it affects the perception of health care advisories who consider the merits of treating the full spectrum of GDM. In an era when evidence-based medical practice should be a guiding principle, GDM can finally now be considered an entity for which recommendations can be based on data derived from clinical trials rather than on solely expert opinion.
According WebMD 2014. Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body's ability to use the energy found in food. There are three major types of diabetes. Type 1 diabetes mellitus, type 2 diabetes mellitus and gestational diabetes. It is a hormonal disorder of the pancreas either decrease in insulin level also known as hypoinsulinism or increase in insulin level also known as hyperinsulinism. Lowered amounts, insufficient of, or ineffective use of insulin leads to the disorder of diabetes mellitus. It is common chronic disease requiring lifelong behavioral and lifestyle changes. According to Peakman (2012). The development of type 1 diabetes mellitus is a genetic and an autoimmune process that results in destruction of the beta cells of the pancreas, leading to absolute insulin deficiency. There is usually a pre-diabetic phase where autoimmunity has already developed but with no clinically apparent insulin dependency. Insulin autoantibodies can be detected in genetically predisposed individuals as early as 6-12 months of age. In persons genetically susceptible to type 1 diabetes, a triggering event, possibly a viral infection the leads to production of autoantibodies that kill the beta cells and results in decline and a lack of insulin secretion. According to Wherrett. It is caused by impaired insulin secretion and insulin resistance and has a gradual onset. Those with type 2 diabetes may eventually need insulin treatment. Gestational diabetes mellitus is glucose intolerance during pregnancy in a woman not previously diagnosed with diabetes, this may occur if placental hormones counteract insulin, causing insulin intolerance. Complications in diabetes mellitus includes: Hypoglycemia it is ca...
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.
The next stage is for the team to jointly develop an evidence-based practice standard based on the information compiled during the research process (Doody & Doody, 2011). An important concept of evidence-based practice as pointed out by Doody & Doody (2011) is the involvement of the patient in the development of new standards. The developed standard should apply to the research topic that is being addressed, however; it should also be modified from person to person based on morals and values for the standard to truly be evidence-based (Doody & Doody,
These women could anticipate delays in normal growth and development for the fetus. The exact cause of post term pregnancy is unknown. The mother experiencing post term pregnancy is at risk for trauma, hemorrhage, infection, and labor abnormalities (Ward et al., 2016, p. 543). Labor induction prior to 42 weeks’ gestation prevents MAS and other complications. A biophysical profile measuring the heart rate, breathing and body movements, tone, and the amniotic fluid volume is used to monitor the fetus for intrapartum fetal stress that could cause passage of meconium. Diabetic woman is at high risk for preeclampsia or eclampsia, infection, hydramnios, postpartum hemorrhage, and cesarean birth (Ward et al., 2016, p. 383). In addition, fetal macrosomia prolongs labor due to shoulder dystocia. The glucose challenge test, and the 3- hour OGTT is used for gestational diabetes screening, done after 24 weeks of pregnancy. Abnormalities of the respiratory system as explained earlier are the most concerning complication of MAS, needing immediate
One of the most crucial health problems affecting the people of Kern County is diabetes. The risk factors include: being over the age of 45 years old, having high blood pressure, having pre-diabetes, coming from an ethnic minority or low income household, smoking, being overweight or obese, physical inactivity, and eating less than five fruits and vegetables a day. Diabetes is a chronic medical condition where people identify themselves with irregular quantities of blood glucose, which can be a cause from deficiencies in the making of insulin. There are two types of diabetes that people are diagnosed with. The first one is known as Type 1 diabetes, which has to do with influences in your genetics, and Type 2 diabetes, which is brought on by choices in your daily routine. Gestational diabetes occurs while you are pregnant, and if it is not monitored well pregnant women can develop Type 2 diabetes within 5-10 years (Diabetes in C...
While a woman is generally safe from complications from gestational diabetes, there are some very big risks to the baby. If gestational diabetes goes undiagnosed, there is a greater risk of stillbirth. Other complications can include a condition called macrosomia, where the baby is born weighing 9 ¾ pounds or more. Excessively large babies can make delivery more difficult for both mother and child and as a result, birth injuries are more common in these babies. Other problems include hypoglycemia in the baby shortly after birth. The risk of gestational diabetes is higher in women who are over 30 years old, have a family history of diabetes, are obese, and those who have previously had a macrosomic baby.
Diabetes is a metabolic disease where the body is unable to produce any- or enough- insulin which causes high glucose levels in return. There are 3 different types of diabetes that people are most familiar with. Type 1 diabetes, which is an autoimmune disease where that person would need insulin from the second they’re diagnosed. Type 2 diabetes, which may take months or even years for a person to require insulin. With type 2 diabetes, the affected person is usually older and overweight. The third type that people are most familiar with is Gestational diabetes. GD occurs during pregnancy. Around 28 weeks gestation, the pregnant woman is instructed to go for a one hour glucose test to check for diabetes. Usually after the pregnancy, the diabetes goes away- although there are some cases where it doesn’t.
Diabetes is a disease that affects the body’s ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, or juvenile diabetes, which usually occurs during childhood or adolescence, and type 2, or adult-onset diabetes, the most common form of the disease, usually occurring after age 40. Type 1 results from the body’s immune system attacking the insulin-producing cells in the pancreas. The onset of juvenile diabetes is much higher in the winter than in the summer. This association has been repeatedly confirmed in diabetes research. Type 2 is characterized by “insulin resistance,” or an inability of the cells to use insulin, sometimes accompanied by a deficiency in insulin production. There is also sometimes a third type of diabetes considered. It is gestational diabetes, which occurs when the body is not able to properly use insulin during pregnancy. Type 2 diabetes encompasses nine out of 10 diabetic cases. Diabetes is the fifth-deadliest disease in the United States, and it has no cure. The total annual economic cost of diabetes in 2002 was estimated to be $132 billion, or one out of every 10 health care dollars spent in the United States. Diabetes risk factors can fall into three major categories: family history, obesity, and impaired glucose tolerance. Minority groups and elderly are at the greatest risk of developing diabetes.
The purpose of this study is to research the disease Type 2 Diabetes and to discover whether it is being effectively treated and prevented in Merced County, California. According to the National Institutes of Health, Diabetes Mellitus is “a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. It is also the most common form of Diabetes”.1 Furthermore, there are many risk and lifestyle factors associated with this disease, but the most prevalent are; obesity (#1 risk factor), sedentary lifestyle, unhealthy eating habits, family history and genetics, increased age, high blood pressure and high cholesterol, and a history of gestational diabetes.2 The long term complications of having type 2 diabetes can include but are not limited to; eye problems (cataracts and glaucoma), foot problems (neuropathy/ nerve damage), skin problems (infections), high blood pressure (which raises your risk for heart attack, stroke, eye problems and kidney disease), hearing loss, oral health, mental health and early death.3
In conclusion, women with a history of gestational diabetes have an increased risk of developing type 2 diabetes in the future. By following health interventions they are able to decrease the chance and can avoid the development of diabetes. Abiding by these healthy lifestyle changes increases quality of life of both mom and infant.
Evidence based practice (EBP) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research" (Sackett et al, 1996). This definition takes into consideration the need to delve into the professional’s clinical knowledge (Burns, 2007) as well as looking into the best evidence to support the professional. Clinical practices may become out dated if new evidence is not sourced and professionals should be aware of appropriate evidence that can be integrated into their practice (Aveyard & Sharp, 2013). EBP is important
In order for clinical policy or guideline to be both evidence based and clinically relevant, it must balance the strengths and weaknesses of all applicable research evidence with the practical realities of the healthcare and clinical settings. This is can be a problematic step because of limitations in both the evidence that is available and in policy making (Donald & Haines, 1998).
There are three types of diabetes, which are Type 1 diabetes, type 2 diabetes, and lastly gestational diabetes. Type 1 diabetes is commonly founded in children and adolescents, this occurs when the pancreas is at a point of not producing insulin. Insulin is naturally produced as a hormone by the pancreas in order to keep the body in homeostasis, then synthetically produced and injected manually to prevent having hyperglycemia. Approximately 10 percent of the society happens to have type 1 diabetes. The other 90 percent of the diabetics have type 2 diabetes; type 2 diabetes is when the pancreas is not producing enough insulin or when the body does not use the insulin produced properly. This type of diabetes occurs mainly in adults and due to this factor, children are at risk of getting diabetes because it is in their genetic traits. Gestational diabetes, which is the third type of diabetes, is considered to be a temporary condition that occurs during pregnancy. The pregnancy is a risk factor for the mother and the child because 2 to 4 percent of all pregnancies involve an increase risk of developing diabetes ("Canadian diabetes association," 2014. p. 1). Diabetes has a large impact on an individual’s life; responsibilities are increased by making sure one is taking the proper dosage of insulin, having the proper amount of food and making sure one gets their proper exercise; though more care is required compared to another individual living a life without any precautions. In Canada the rate of diabetes is slowly increasing due to many other factors. According to the Canadian Diabetes Association (2014), it is estimated that out of the nine million Canadians, approximately 5.4 million have pre-diabetes (p.1).
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 pregnancy causes the body to be less sensitive to insulin. Insulin has the job of opening up the cells so that the glucose can get inside regulating the amount of glucose in the blood while glucose is the amount of sugar in the blood stream. In pregnancy, the body needs to make three times more insulin for control of the blood sugar. GDM is usually found within the second trimester of a pregnancy and increases until the end of the pregnancy. Usually within a few hours of delivery the condition resolves itself (American Diabetes Association, 2010).
GDM usually disappears after the baby is born due to the placenta being removed, the hormones it was producing, which caused the insulin resistance, are also removed. If the blood sugar does not return to normal, it may indicate that the patient may have had diabetes before pregnancy.