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Essay gestational diabetes mellitus in Obstetrics
Literature review gestational diabetes
Literature review gestational diabetes
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Pregnancy is one of life’s greatest miracles that a woman gets to experience during her lifetime. However, sometimes in life certain obstacles come into play that can interfere with pregnancy. One of these obstacles is Gestational Diabetes Mellitus. According to diabetes.org, “Gestational Diabetes is a condition where women who have never had diabetes have high blood glucose (sugar) levels during pregnancy.” Gestational Diabetes begins when the body is not able to produce and use the right amount of insulin that is needed to sustain pregnancy. It is shown that the prevalence rate for Gestational Diabetes is about 16.1% and it is a common factor that is increasing worldwide. Sadly, research has stated that the chances of developing gestational …show more content…
Studies have shown that having a higher BMI before or during the first trimester and excessive weight gain during early and mid-pregnancy are early markers for gestational diabetes mellitus. Studies have also concluded that women with a high pre-pregnancy BMI and a high gestational weight gain increases the risks of gestational diabetes mellitus by 2.2 to 5% fold. Currently, researchers are trying to determine how to reduce the risks that gestational diabetes mellitus has in pregnant mothers. Present day research has concluded with a theory that physical exercise plays an important role in preventing and reducing the risks gestational diabetes mellitus in pregnant mothers. There are three research studies that help study the relationship between exercise and the reduction of the risks of gestational diabetes mellitus which include: Prospective Study of Gestational Diabetes Mellitus Risk in Relation to Maternal Recreational Physical Activity before and during Pregnancy, Objectively recorded physical activity and the association with gestational diabetes, and Exercise intervention during pregnancy can be used to manage weight gain and improve pregnancy outcomes in women with gestational diabetes …show more content…
It is reported that regular or a little bit of exercise can reduce the risks associated with gestational diabetes. Some of the risks include insulin resistance, oxidative stress, increased body fat, and high blood pressure. Also, it has shown that peripheral insulin resistance is a risk factor. In the past, there have been studies showing the reduction of risks involved in Gestational Diabetes are to physical activity. While these results from the studies are proof, these studies have possible bias due to self-reported physical activity. Due to this problem, the purpose of this study is to further test the hypothesis that physical activity reduces the risks of gestational diabetes. For the experimental design, researchers used participants from the Omega study which was made to examine dietary risk factors in pregnant women which were attending prenatal care. These women had to be 18 or older, had to speak English, and needed to carry out the pregnancy term. In this study, they had to perform a 48-60 minute interview regarding their maternal sociodemographic characteristics, lifestyle habits, and medical history.
A 46-year-old Hispanic man presented to the clinic for a routine physical and a review of his recent laboratory studies. His medical history was significant for high cholesterol. His daily medication regimen included a multivitamin, aspirin 81 mg, and simvastatin (Zocor) 40 mg for high cholesterol. His family history was remarkable for type 2 diabetes, hypertension, and hyperlipidemia in his mother, maternal grandmother, maternal aunt, and maternal uncle. Physical examination revealed a height of 69 inches, weight of 199 pounds, body mass index (BMI) of 29.4 kg/m2, waist circumference of 36 inches and blood pressure of 125/72 mm Hg. Initial laboratory results were: total cholesterol 195 mg/dL; triglycerides 136 mg/dL; low-density lipoprotein cholesterol (LDL), 124 mg/dL; high-density lipoprotein cholesterol (HDL), 44 mg/dL; and fasting plasma glucose (FPG), 119 mg/dL. Complete blood count, renal function and liver function tests were all normal. Additional studies included an oral glucose tolerance test (OGTT) of 157 mg/dL and hemoglobin A1c (HbA1c) of 5.9%. The patient’s physical exam was unremarkable with no abnormalities noted.
4: Evers IM, De Valk HW, Visser GHA (2004) Risk of complications of pregnancy in women with Type 1 diabetes: Nationwide prospective study in the Netherlands. British Medical Journal 328, 915-917.
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...
The pathophysiology of diabetes mellitus in is related to the insulin hormone. Insulin is secreted by cells in the pancreas and is responsible for regulating the level of glucose in the bloodstream. It also aids the body in breaking down the glucose to be used as energy. When someone suffers from diabetes, however, the body does not break down the glucose in the blood as a result of abnormal insulin metabolism. When there are elevated levels of glucose in the blood, it is known as hyperglycemia. If the levels continue to remain high over an extended period of time, damage can be done to the kidneys, cardiovascular systems; you can get eye disorders, or even cause nerve damage. When the glucose levels are low in one’s body, it is called hypoglycemia. A person begins to feel very jittery, and possibly dizzy. If that occurs over a period of time, the person can possibly faint. Diabetes mellitus occurs in three different forms - type 1, type 2, and gestational.
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...
6. Radenković, O., Kahrović, I., & Murić, B. (2013). Role of Physical Activity in the Prevention and Treatment of Diabetes.. Activities In Physical Education & Sport, 3(1), 41-43.
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.
Most women with gestational diabetes return to normal glucose tolerance postpartum, however, they are at increased risk of developing gestational diabetes in any additional pregnancies and for getting type 2 diabetes later in life. Lifestyle modifications aimed at reducing or preventing weight gain and increasing physical activity after pregnancy is recommended and can reduce the risk of subsequent diabetes.
Hu, F. B., Manson, J. E., Stampfer, M. J., Colditz, G., Liu, S., Solomon, C. G., & Willett, W. C. (2001). Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England Journal of Medicine, 345(11), 790-797.
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.
Watson, P. & McDonald, B. (2007) Activity levels in pregnant New Zealand women: relationship with socioeconomic factors, well-being, anthropometric measures, and birth outcome. Applied Physiology, Nutrition & Metabolism 32 (4), 733-742.
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 in 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.
Obesity is characterized by comparing height and weight measurement to determine a Body Mass Index as normal, overweight or obese. African- American women maintain the highest rates of obesity, infant mortality and pre-term births in comparison to non-Hispanic Caucasian women (Isaac & Thomas, 2013). According to the text Race, Ethnicity and Health, obesity rates for African-American women between ages two to nineteen was 24%, and obesity rates for Caucasians was 14%. Considering these facts, many women are unaware of the adverse effects that becoming pregnant with high BMI indexes or gaining too much weight during pregnancy can have on the fetus and the mother. It is important for women to understand what a healthy amount of weight to gain based on their personal proportions. “The recommended gain for women of normal size (BMI 19.8- 26) is 11.5- 16kg; for women with low BMI (below 19.8), the recommended gain is 12.5- 18 kg; where, for women with a high BMI (above 26-29), it is 7-11.5 kg. The target gain for obese women (BMI above 29) is at least 6.8 kg” (Hickey, 1997). Also not gaining enough weight can have adverse effects on the fetus. The high prevalence of gestational obesity in the African American community would be beneficial to educate women on the detrimental life span idiopathic diseases that affect infants, complicate pregnancies and deliveries through individual readiness plans at a local community health center.
The primary method to control gestational diabetes mellitus (GDM) is through dietary regulation. The most effective method to control GDM via diet is through carbohydrate restriction and/or selectivity. It is recommended that pregnant women with GDM reduce their carbohydrate intake to 40% of the total caloric intake or can maintain a 60% carbohydrate intake but those carbohydrates must all come from low glycemic index foods. Examples of low glycemic foods are apples, spinach, black beans, split peas, oatmeal, and quinoa. Additional suggestions are to eat complex carbohydrates instead of simple, refined sugars. Eat small, frequent meals and snack often in between meals in order to maintain constant glucose levels throughout the day.
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.