Women With and Without Gestational Diabetes - Dissertation Example

Introduction The incidence of gestational diabetes (GDM) occurs between 2% to 5% of all pregnancies (Gilmartin, Ural and Repke, 2008). Specificallythe lifetime risk of developing Type II diabetes after being diagnosed with GDM is between 30% (Kirk and Namak, 2009). In most cases, pregnant women who are either overweight or obese have higher risk of developing GDM. Due to the increased risk of developing type II diabetes after pregnancy, a lot of past and current studies were focused on analyzing the significance of lifestyle and poor diet in the development of GDM (Vargas, Repke and Ural, 2010; Clerisme-Beaty and Rand, 2009; Franz and Rosett, 2007; Brewster et al., 2006). The risk factors behind the development of GDM includes being overweight or obese even before women becomes pregnant (Clerisme-Beaty and Rand, 2009; Brewster et al., 2006). The problem with developing GDM is that women diagnosed with this kind of symptoms during pregnancy have higher risks of developing type II diabetes after pregancy (Clerisme-Beaty and Rand, 2009). In worst case scenario, women with GDM can increase the unborn child’s risk of experiencing more complications after birth. Often times, these complications include: above the normal child’s birth weight (> 4 kg) (Maicon et al., 2012; Vijan, 2010), macrosomia resulting to shoulder dystocia (Conway, 2007), premature birth, and passing the high blood glucose to the fetus via placental pathways and increased risk of becoming obese (Baris et al., 2008), Lack of exercise when combined with poor diet such as eating foods with high sugar content, foods rich in carbohydrates such as pasta, potatoes, and rice or eating foods that contain calories more than what the mother and the fetus needs can lead to the development of GDM (Franz and Rosett, 2007). Over the basal metabolic needs or calorie intake of the mother, mothers who are nurturing only one fetus should limit their added calorie intake to only 300 kcal (Vargas, Repke and Ural, 2010). In line with this, Gabbe and Gravis (2003) mentioned that pregnant women with normal body weight should consume only 30 to 35 kcal/kg of calorie as this is enough to support both the child’s and the mother’s energy needs. For example, with regards to fat intake, pregnant women with GDM should not consumer more than 35% of their total daily energy requirement whereas consumption of trans fat and saturated fats should be strictly limited to at least 10% of their daily needs (Bantle et al., 2006). Pregnant women should take just enough energy requirement from foods. To avoid developing GDM, pregnant women should limit their intake of carbohydrates. Aside from maintaining weight, pregnant women should avoid ketoacidosis or starvation ketosis. Since the intake of foods and nutrients is one of the main factors that can trigger the development of GDM, this study will discussed the proposed research method on how the researcher will use of cases complete food diary for 7 days and the net wisp program to effectively compare the nutrient intakes of women with and without gestational diabetes. Weight Classifications The World Health Organization (2006) reported that an overweight woman’s BMI usually fall between 25.0 kg/m2 to 29.9 kg/m2 whereas the BMI of obese women is usually between 30.0 kg/m2 to 34.9 kg/m2. After making some adjustments in the computation of accepted BMI for pregnant women, it was reported by Catalano et al. (2012) that pregnant women’s BMI at 28 to 29 weeks gestation should be between 28.5 kg/m2 to 32.9 kg/m2 whereas overweight pregnant women are classified by having BMI more than 33.0 kg/m2. Methodology To address the main purpose of this study, this study adopted the use of the food dairy method and the Net wisp program. All of the 120 pregnant women who agreed to participate in this study were asked to complete the 7-day food diary at 28 weeks of gestation. The main reason why pregnant women at 28 weeks of gestation were requested to complete the food diary is because this is the stage of pregnancy wherein pregnant women are no longer experiencing too much nausea and vomiting which may affect their usual eating habit (Huxley, 2000). The food diary method was used to collect data with regards to the research participants’ food and drinks consumption on a per day basis for at least seven (7) consecutive days. On the 28th week of pregnancy, each of the research participants was requested to hand in their individual food dairy on the same day they had agreed to undergo fasting and random blood testing. For example, under the different food categories (i.e. meat and fish, fruits and vegetables, cereals, bread, puddings, milk and tea, etc.) specified in the food diary form, each of the pregnant women with and without gestational diabetes were instructed to record the kind of foods they consume throughout a day for the entire duration of 7 day-period. Aside from the frequency of their food intake throughout the 7-day period, each of the pregnant women with and without gestational diabetes were requested to state the kind of foods they prefer to eat outside the food categories mentioned in the food diary form. The total of number in Belfast cohort is 1639. Using inclusion and exclusion method, a total of 120 samples were included in this study. Based on the 120 samples that were gathered in this study, a total of 40 research participants with gestation diabetes mellitus (GDM) and the rest of the 80 research participants who are free from having GDM were purposely selected in this study. Data derived from the 7-day diaries (n=120) such as the type of foods and food serving were encoded in the WISP nutritional analysis programme using the standardised codes for foods. The research faced quite a lot of difficulty while trying to gather and analyze the information taken from the food diaries. First of all, there were some instances wherein the researcher had encountered some unknown kind of foods that were recorded in the food diaries. There were also some cases wherein the research participants failed to record the size portion of their food intake. Other research study limitations includes the use of home food measurement and the risks wherein the research participants had misreported the kind of food they eat and the size of meal portion they had consume throughout each meal. References Bantle, J., Wylie-Rosett, J., Albright, A., Apovian, C., Clark, N., Franz, M., et al. (2006). Nutritional Recommendations and Interventions for Diabetes. Diabetes Care, 29(9), pp. 2140-2157. Baris, A., Aygul, C., Serkan, Y. and Sena, Y. (2008). Is fasting glucose level during oral glucose tolerance test an indicator of the insulin need in gestational diabetes? Diabetes Research and Clinical Practice, 82(2), pp. 219-225. Brewster, M., Herrmann, T., Bleisch, B. and Pearl, R. (2006). A gender perspective on water resources and sanitation. Wagadu. A Journal of Transnational Women's and Gender Studies, 3, pp. 1-23. Catalano, P., McIntyre, D., Cruickshank, J., McCance, D., Dyer, A., Metzger, B., et al. (2012). The Hyperglycemia and Adverse Pregnancy Outcome Study. Associations of GDM and obesity with pregnancy outcomes. Diabetes Care, 35(4), pp. 780-786. Clerisme-Beaty, E. and Rand, C.S. (2009). The effect of obesity on asthma incidence: Moving past the epidemiologic evidence. Journal of Allergy and Clinical Immunology, 123(1), pp. 96-97. Conway, D. (2007). Obstetric Management in Gestational Diabetes. Diabetes Care, 30(Suppl2), pp. S175-S179. Franz, M. and Rosett, I. (2007). The 2006 American Diabetes Association Nutrition Recommendations and Interventions for the Prevention and Treatment of Diabetes. Diabetes Spectrum, 20(1), pp. 49-52. Gabbe, S. and Gravis, C. (2003). Management of Diabetes mellitus complicating pregnancy. Obstetric Gynecology, 102(4), pp. 857-868. Gilmartin, A., Ural, S. and Repke, J. (2008). Gestational Diabetes Mellitus. Obstetrics & Gynecology, 1(3), pp. 129-134. Huxley, R. (2000). Nausea and vomiting in early pregnancy: its role in placental development. Obstetrics & Gynecology, 95(5), pp. 779-782. Kirk, J. and Namak, S. (2009). Diabetes: Rethinking risk and the Dx that fits. Journal of Family Practice, 58(5), pp. 248-256. Maicon, F., Maria, I., Janet, T., Luísia, F., Eliana, R., Maria, R., et al. (2012). Effectiveness of gestational diabetes treatment: A systematic review with quality of evidence. Diabetes Research and Clinical Practice, 22(2), pp. 421-432. Vargas, R., Repke, J. and Ural, S. (2010). Type 1 Diabetes Mellitus and Pregnancy. Reviews in Obstetrics & Gynecology, 3(3), pp. 92-100. Vijan, S. (2010). Type 2 diabetes. Annals of Internal Medicine, 152(5), pp. ITC31-15. Read More