Gestational Diabete - Research Paper Example

? GESTATIONAL DIABETES (12 July GESTATIONAL DIABETES Gestational Diabetes (GD) is a serious problem faced by several women during pregnancy. The high blood sugar during pregnancy is mainly linked to the hormonal changes that inhibit the production of insulin. It is a very common problem and about 4 % of all pregnant women have GD. In other words in every 100 pregnancy in US, 3 to 8 women get GD. It is important to keep a check on the blood glucose level because an increased glucose level can result in deformities in the baby. Fetal and neonatal problems that are linked with GD mainly include amplified risk for miscarriage, stillbirth and macrosomia. A regular check and a good meal plan together with physical activity can help pregnant women with GD to have healthy babies. GESTATIONAL DIABETES INTRODUCTION Gestational Diabetes (GD) as the name suggests refers to the diabetes that occurs during pregnancy. It is a serious problem that can be detrimental for both mother and child if not checked regularly. The high blood sugar during pregnancy is mainly linked to the hormonal changes that inhibit the production of insulin. Statistics suggest that about 4 % of all pregnant women have GD. According to the statistical data, in every 100 pregnancy in US, 3 to 8 women get GD that is type-2 diabetes. It is anticipated that about 135,000 cases of GD take place in the US annually (Diabetesinformationhub.com, 2011). Though it is a common problem it is important to keep a check on the blood glucose level because an increased glucose level can result in deformities in the baby. In general the fetal and neonatal problems that are linked with GD mainly include amplified risk for miscarriage, stillbirth and macrosomia (Big baby). A regular check and a good meal plan together with physical activity and proper medication can help pregnant women with GD to have healthy babies. CAUSES AND RISK FACTORS OF GESTATIONAL DIABETES Diabetics are the result of low insulin production or insulin resistance. When this occurs during pregnancy, it is mainly due to the hormonal activity that blocks insulin from doing its job. Hence GD is a temporary problem and after pregnancy the insulin production becomes normal. However during pregnancy the high glucose levels may be a serious problem and needs good care from the medical team (NCBI, 2010). The main hormones that are responsible in development of placenta during pregnancy are involved in blocking the activity of insulin in the body. In other words the insulin become resistant and does not function normally during pregnancy. Additionally, studies point out that during pregnancy the need of insulin production is about 3 times when compared to normal period. For instance, a mother may require up to three times more insulin for the conversion of glucose to the energy. The need for energy is very high during pregnancy. When body is unable to use insulin due to insulin resistance GD develops. If the high blood glucose level is not kept under check it may lead to hyperglycemia which is dangerous for both mother and child. GD does not usually start until halfway of the pregnancy. It is a common practice to during pregnancy between the 24th and 28th week to receive an oral glucose tolerance test to screen for GD. Women who have risk factors for gestational diabetes may have this test earlier in the pregnancy. Further, the symptoms of GD include blurred vision, fatigue, increased thirst, increased urination, infections in the bladder, vagina and skin, nausea and vomiting and also weight loss in spite of increased appetite (NCBI, 2010). The high risk for GD include the age factor, family history, GD in earlier pregnancies, high urine sugar, high blood pressure, increased amniotic fluid, earlier cases of miscarriages and stillbirths, and also overweight or obese before pregnancy. Chances of GD are high in case the woman is older than 25 years when pregnant. Additionally if the blood relations such as father, mother or siblings of the woman have a history of diabetes, then the chances of GD is still high (NCBI, 2010). Women belonging to any of the following races i.e. African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander have higher risks of developing GD during pregnancy. DIAGNOSIS OF GD It is a regular procedure to check the blood glucose level during pregnancy. The high risk category of people may be tested at as early as 13 weeks of pregnancy. In general, GD is identified through a glucose tolerance test, taken between 24 – 28 weeks of pregnancy. During the glucose tolerance test the pregnant women is given a measured quantity of glucose solution to drink and at intervals of one hour, two hours and three hours the blood glucose level is checked. If the results find any value that is below 140 mg/dl, the pregnancy can be considered non diabetic. Any value higher than 140 mg/dl, are considered at the risk of GD. Further, tests are carried out to confirm the results. This mainly involves a three-hour glucose tolerance test will be performed. This involves a systematic measurement and requires the women to eat a diet of at least 150 grams of carbohydrates for three days prior to the test. Further they are asked to be on fast for 10 to 14 hours before the test. During this period, the woman should not eat or drink anything but water. The test begins with the morning blood sample to check the fasting glucose level. After which the woman will drink a measured quantity of glucose solution and blood will be taken on an hourly bases for three hours. The test results are then compared with the standard values. If two or more of the glucose levels are elevated than the standard values, a diagnosis of GD can be made (The HealthCentralNetwork, 2010). TREATMENT The main aim of treatment of GD is to keep blood sugar (glucose) levels within normal limits during the pregnancy. This will not only ensure the health of the mother but also help the maintenance of health of the baby. One of the most important step towards healthy pregnancy with GD is to keep a check of blood glucose level on a daily bases. Additionally, it is also important for regular health check up and monitor the fetal size, level of amniotic fluid, movement and heart beat of the baby etc. DIET AND EXERCISE The first step in maintaining healthy pregnancy with GD is modifying the diet and including a variety of foods with good nutrition. Food labels and the energy content in each food need to be calculated when making food decisions. It is necessary that a woman with GD should consume diet that should be judicious in fat and protein and supply restricted levels of simple and complex carbohydrates. It is also important to cut down on foods that contain a high amount of sugar, such as cakes, carbonated soft drinks, fruit juices, and pastries. In general it is suggested to have small- to moderate-sized meals and one or more snacks three to five times on a day to day basis. It is also important to maintain proper time for meals and snacks and should not skip any meal. Depending on the type of diet the physicians may suggest additional vitamin and mineral supplementation. Regular exercise such as walking and other simple exercises that can be done during pregnancy aid in burning out excess energy that will add to a healthy pregnancy. MEDICATION In most of the cases it is possible to manage GD with diet modifications. In a few cases if the diet does not control blood sugar (glucose) levels, oral diabetes medicine such as Metformin or injections of insulin may be suggested. It is important to monitor the blood glucose level on a daily basis and depending on the values obtained the physician may increase or decrease the dosage of these medications. Even though many women with GD will not need diabetes medicines or insulin, it may not be possible for some to control it without medication. EXPECTATIONS (PROGNOSIS) Most of the women are able to control the blood glucose levels using diet, exercise, oral medicines and injections and avoid any harm to self and baby. However, in most of the GD cases the babies tend to be larger in size and at times may lead to problems in normal delivery. For instance, there are chances of Birth injury (trauma) because of the baby's large size and also delivery may be by c-section. In many cases the babies are more likely to have periods of low blood sugar or hypoglycemic during the first few days of life. Hence, the pediatrics support may become essential in the early days. Additionally, there are also chances that the mothers develop high blood pressure during pregnancy. In rare cases if the sugar levels are not monitored there are chances of baby dying. After the delivery, the women with GD will be normal and need not continue the diabetic drugs. However, it is important to note that these women are at high risk of getting type 2 diabetics in future (NCBI, 2010). Statistics point out that soon after pregnancy, about 5-10% of women with GD are found to have type-2 diabetes. Besides, according to the American Diabetes Association women who have had GD have up to sixty percent chance of developing diabetes in next ten to twenty years (diabetes.org, 2010). Hence, it is essential to manage weight and follow healthy low calorie diet. CONCLUSION Pregnancy is among the most important phases in a woman’s life. Problems such as gestational Diabetes are serious problem that need to be controlled. Though this is a temporary problem during pregnancy, it should not be ignored. A team effort is essential involving the pregnant women, physicians, dietitians, nursing community, diabetologists and gynecologist. This combined effort can help healthy pregnancy and can reduce the incidences of miscarriage, stillbirth and macrosomia. To sum up a regular check of blood glucose level and a good meal plan together with physical activity can help pregnant women with GD to have healthy babies. References Diabetesinformationhub.com, (2011) Gestational Diabetes. Retrieved from http://diabetesinformationhub.com/GestationalDiabetes.php diabetes.org, (2010) American Diabetes Association Fact Sheet. Retrieved from http://www.diabetes.org/in-my-community/local-offices/miami-florida/assets/files/ada-fact-sheet-2011-one-pager.pdf National Center for Biotechnology Information (NCBI), (2010) Gestational diabetes- Glucose intolerance during pregnancy. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001898/ The HealthCentralNetwork, (2010) Health Encyclopedia - Diseases and Conditions : Gestational diabetes. Retrieved from http://www.healthscout.com/ency/68/203/main.html Read More