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Essay: Gestational diabetes – nature, risk factors, screening, treatment

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  • Published: 15 October 2019*
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  • Words: 2,567 (approx)
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  • Tags: Diabetes essays

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The prevalence of gestational diabetes mellitus (GDM) has increased recently worldwide. If we want to understand the nature of this disorder, we have to know that Gestational diabetes might appear during pregnancy. Like other types of diabetes, gestational diabetes influences how cells use glucose in our bodies. Usually it causes high blood sugar that can affect female pregnancy and baby’s health.
Expectant moms can help to reduce the chance of getting gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Regulating blood sugar can stop a difficult birth and keep the mom and her baby healthy.

Usually, in gestational diabetes, blood sugar usually returns to normal soon after delivery. But if the mother has had gestational diabetes, she is at risk for type 2 diabetes. In this case, she needs to continue working with your health care team to monitor and manage her blood sugar.
In general, treating gestational diabetes can help both the mother and her baby stay healthy. The mother can protect her baby and herself by taking action right away to control her blood glucose levels.
This report will give a brief about the Gestational diabetes disease and the main causes of it. It shows the main symptoms and the diagnoses and the treatment methods.

The nature of the disease cause

Gestational diabetes happens when mom body can’t make enough insulin during her pregnancy. Insulin is a hormone made in the pancreas, an organ located behind your stomach. Insulin helps the body to use glucose for energy and helps control blood glucose levels.
During pregnancy, mom body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body’s need for insulin. If mom pancreas can’t make enough insulin, she will probably have gestational diabetes.
Epidemiology of Gestational Diabetes
Gestational diabetes (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. Although it is a well-known cause of pregnancy complications, its epidemiology has not been studied systematically.

The Risk Factors

The main risk factors of Gestational diabetes mellitus is more likely with
• Increasing age
• Certain ethnic groups (Asian, African Americans, Hispanic/Latino Americans and Pima Indians)
• High BMI before pregnancy (three-fold risk for obese women compared to non-obese women)
• Smoking doubles the risk of GDM
• Change in weight between pregnancies – an inter-pregnancy gain of more than three units (of BMI) doubles the risk of GDM
• Short interval between pregnancies
• Previous unexplained stillbirth
• Previous macrosomia.
• Family history of type 2 diabetes or GDM – more relevant in nulliparous than parous women.
Gestational Diabetes Symptoms
For most women, gestational diabetes doesn’t cause noticeable signs or symptoms. Because gestational diabetes does not cause symptoms, the mom needs to be tested for the condition. This is usually done between the 24th and 28th weeks of pregnancy. You may be surprised if your test shows a high blood sugar level. It is important for you to be tested for gestational diabetes, because high blood sugar can cause problems for both the mom and her baby.
The Diagnoses
After reviewing various articles, I recognized that medical experts haven’t agreed on a single set of screening guidelines for gestational diabetes. Some of them questioned whether gestational diabetes screening is needed if the female is younger than 25 and have no risk factors. Others say that screening all pregnant women is the best way to identify all cases of gestational diabetes.
Usually, the doctor will likely evaluate the risk factors for gestational diabetes early in stage of pregnancy. There are several methods to diagnose, some of them are explained below
The mother may be screened for gestational diabetes at her first antenatal appointment with her midwife or General Practitioner, which takes place around weeks 8-12 of her pregnancy.
At this time, the midwife will find out if mom is at increased risk of gestational diabetes. She will ask about any known risk factors for gestational diabetes, such as whether she has a family history of diabetes.
If any of risk factors apply to her, she will be offered a blood test to check her glucose levels. This may also include a glucose tolerance test (GTT).
Glucose tolerance test (GTT)
This test takes place during weeks 24-28 of pregnancy. This involves a morning blood test, before the mother has eaten breakfast. She is then given a glucose drink, and another blood sample is taken two hours later to see how her body is dealing with the glucose.
If the mother had gestational diabetes in a previous pregnancy, the GTT will be carried out at weeks 16-18 of pregnancy – or sooner, if indicated by the first blood glucose sample. This is followed by a repeat GTT at 28 weeks, if the first test is normal.
When the mother is diagnosed with gestational diabetes
If the pregnant woman is diagnosed with gestational diabetes, her doctor will likely recommend frequent checkups, especially during her last three months of pregnancy. During these exams, your doctor will monitor your blood sugar. Her doctor may also ask her to monitor her own blood sugar daily as part of your treatment plan.
If the mother is having trouble controlling her blood sugar, she may need to take insulin. If she has other pregnancy complications, she may need additional tests to evaluate her baby’s health. These tests assess the function of the placenta, the organ that delivers oxygen and nutrients to the baby by connecting the baby’s blood supply to the mom.
How will gestational diabetes affect the baby?
If the mother has high blood glucose levels because her gestational diabetes is not under control, her baby will also have high blood glucose. The baby’s pancreas will have to make extra insulin to control the high blood glucose. The extra glucose in the baby’s blood is stored as fat. In fact untreated or uncontrolled gestational diabetes can cause problems for your baby, such as:
• having low blood glucose, also called hypoglycemia, right after birth
• having breathing problems, a condition called respiratory distress syndrome
• having a higher chance of dying before or soon after birth
How will gestational diabetes affect the mother?
In general, gestational diabetes may increase chances of:
• having high blood pressure and too much protein in the urine, a condition called preeclampsia
• having surgery—called a cesarean section or c-section—to deliver your baby because your baby may be large
• becoming depressed
• developing type 2 diabetes and the problems that can come with this disease
Preeclampsia occurs during the second half of pregnancy. If not treated, preeclampsia can cause problems for her baby that could cause death. The only cure for preeclampsia is to give birth. If the mother develops preeclampsia late in her pregnancy, she may need to have a cesarean section to deliver her baby early. If she develops preeclampsia earlier, she may need bed rest and medicines, or she may have to be hospitalized to allow her baby to develop as much as possible before delivery.
Depression can make the mother too tired to manage her diabetes and care for her baby. If during or after her pregnancy she feels anxious, sad, or unable to cope with the changes she is facing, talk with her health care team. Depression can be treated. Her health care team may suggest ways and she can get support and help to feel better. Remember, in order to take care of her baby, she must first take care of herself.
How is gestational diabetes treated?
In fact, treating gestational diabetes indicates taking steps to keep the blood glucose levels in a target range. Targets are numbers that the mother aims for. The doctor will help the patient set her targets. She will learn how to control her blood glucose using the following techniques;
• Healthy eating
Research article indicated that using a healthy eating plan will help your blood glucose stay in your target range. The plan will help you know which foods to eat, how much to eat, and when to eat. Food choices, amounts, and timing are all important in keeping your blood glucose levels in your target range.
Your health care team will help you make a healthy eating plan with food choices that are good for both you and your baby. These choices are good for you to follow throughout pregnancy and after, as you raise your family.
• Physical activity
Physical activity can help you reach your blood glucose targets. Usually try to talk with your doctor about the type of activity that is best for you. If you are already active, tell your doctor what you do. Being physically active will also help lower your chances of having type 2 diabetes—and its problems—in the future. Now is the time to develop good habits for you and your baby.
Be as physically active as you can. Aim for at least 30 minutes most days of the week.
Do aerobic activities, which use your large muscles to make your heart beat faster. Try brisk walking, swimming, dancing, or low-impact aerobics.
• Insulin shots, if needed
If you have trouble meeting your blood glucose targets, you may need to take a medicine called insulin, along with following a healthy meal plan and being physically active. Your health care team will show you how to give yourself insulin shots. Insulin will not harm your baby.
Treatment Overview
Treatment of GDM and good glycogenic control reduce serious prenatal morbidity and may also improve the woman’s health-related quality of life. Most women who have gestational diabetes give birth to healthy babies. Treatment for gestational diabetes involves making healthy choices. Most women who make changes in the way that they eat and how often they exercise are able to keep their blood sugar level within a target range. Controlling your blood sugar is the key to preventing problems during pregnancy or birth.
To treat your gestational diabetes, your doctor will ask you to:
• Check your blood sugar levels four or more times a day.
• Do urine tests that check for ketones, which mean that your diabetes is not under control
• Eat a healthy diet that’s in line with your doctor’s recommendations
• Make exercise a habit
• Your doctor will track how much weight you gain and let you know if you need to take insulin or other medicine for your gestational diabetes.
Treatment for gestational diabetes during pregnancy includes:
Eating balanced meals
After you find out that you have gestational diabetes, you will meet with a registered dietitian to create a healthy eating plan. You will learn how to limit the amount of carbohydrate you eat as a way to control your blood sugar. You may also be asked to write down everything you eat and to keep track of your weight. You will learn more about the range of weight gain that is good for you and your baby. Going on a diet during pregnancy is NOT recommended.
Getting regular exercise
Try to do at least 2½ hours a week of moderate exercise. One way to do this is to be active 30 minutes a day, at least 5 days a week. It’s fine to be active in blocks of 10 minutes or more throughout your day and week. Regular, moderate exercise during pregnancy helps your body use insulin better and helps control your blood sugar level. If you have never exercised regularly or were not exercising before you became pregnant, talk with your doctor before you start exercising. Low-impact activities, such as walking or swimming, are especially good for pregnant women. You may also want to try special exercise classes for pregnant women.
Getting regular medical checkups
Having gestational diabetes means regular visits to your doctor. At these visits, your doctor will check your blood pressure and test a sample of your urine. You will also discuss your blood sugar levels, what you have been eating, how much you have been exercising, and how much weight you have gained.
Taking diabetes medicine and insulin shots
The first way to treat gestational diabetes is by changing the way you eat and exercising regularly. If your blood sugar levels are too high, you may need diabetes medicine or insulin shots. If diet and exercise aren’t enough, you may need insulin injections to lower your blood sugar. Between 10 and 20 percent of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors prescribe an oral blood sugar control medication, while others believe more research is needed to confirm that oral drugs are as safe and as effective as inject able insulin to control gestational diabetes.
Close monitoring of your baby
An important part of your treatment plan is close observation of your baby. Your doctor may monitor your baby’s growth and development with repeated ultrasounds or other tests. If you don’t go into labor by your due date — or sometimes earlier — your doctor may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.
Coping and support
Usually, it’s stressful to know you have a condition that can affect your unborn baby’s health. But the steps that will help control your blood sugar level — such as eating healthy foods and exercising regularly — can help relieve stress and nourish your baby and help prevent type 2 diabetes in the future. That makes exercise and good nutrition powerful tools for a healthy pregnancy as well as a healthy life — for you and your baby.
You’ll probably feel better if you learn as much as you can about gestational diabetes. Talk to your health care team. Read books and articles about gestational diabetes. Join a support group for women with gestational diabetes. The more you know, the more in control you’ll feel.
In summary there are some important points to remember;
• Gestational diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high.
• Gestational diabetes happens when your body can’t make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels.
• You will probably be tested for gestational diabetes between weeks 24 and 28 of your pregnancy. If you have a higher chance of getting gestational diabetes, your doctor may test you for diabetes during your first visit after you become pregnant.
• If you have high blood glucose levels because your gestational diabetes is not under control, your baby will also have high blood glucose.
• Untreated or uncontrolled gestational diabetes can cause problems for your baby.
• Treating gestational diabetes means taking steps to keep your blood glucose levels in a target range.
• Even if your blood glucose levels return to normal after your pregnancy, your chances of getting diabetes—usually type 2 diabetes—later in life are high. Therefore, you should be tested at least every 3 years for diabetes or prediabetes.
• You can give your baby a healthy start by breastfeeding.
• You can help your child be healthy by showing your child how to make healthy lifestyle choices, including being physically active, limiting screen time in front of the TV or video games, eating a healthy diet, and staying at a healthy weight.

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