P5#1

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Mara-Lynn DeAngelis 

Week 5 Initial Post- Gestational Diabetes

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Introduction

            Diabetes is the most common endocrine disorder. Diabetes is a disorder of carbohydrate metabolism. Symptoms are caused by insulin deficiency or cellular resistance to the actions of insulin. Impaired glucose uptake and increased glucose production result in elevated blood glucose levels (Rosenthal & Burchum, 2018). Diabetes affects more than 30 million Americans and is the seventh leading cause of death in the United States (ADA,n.d.). There are multiple types of diabetes but I am only going to discuss Gestational diabetes.

Gestational Diabetes (GD)

            Gestational diabetes (GD) is any degree of glucose intolerance with onset or first recognition during pregnancy (Huether & McCance, 2017). In the United States GD affects approximately 9% of the general population, and 30% of Native American women. GD resolves after delivery and may recur with subsequent pregnancies (Hammer & McPhee, 2019).

Treatment for GD

            Insulin is the preferred drug for managing GD. The goal of insulin therapy is to prevent complications by keeping glucose levels within an acceptable range. Blood glucose levels must be closely monitored, and insulin must be titrated to keep glucose levels within a desired range (Rosenthal & Burchum, 2018). Recent studies have shown that Metformin is an acceptable alternative to insulin for treatment of GD. Outcomes of the studies were that the patients treated with Metformin had essentially the same outcomes as those treated with insulin (Rosenthal & Burchum, 2018).

Dietary Considerations

            Adhering to a strict diet is essential in controlling GD. Pregnant women with GD should eat plenty of whole fruits and vegetables, moderate amounts of lean proteins, healthy fats, and whole grains. High sugar foods and beverages such as soft drinks and cakes should be avoided as well as fatty foods. Meals should be small to moderate in size, and snacks should be included. It is important that the number of meals and snacks are consistent from day to day. Carbohydrates should be counted and equal less than half of all calories consumed (MedlinePlus, n.d.).

Short-Term and Long-Term Impact

            GD affects a pregnant woman short-term. The onset of GD typically occurs in the second half of pregnancy and resolves upon parturition (Hammer & McPhee, 2019). Long-term effects of GD are that it may recur in subsequent pregnancies (Hammer & McPhee, 2019) and women that have GD are at a higher risk for developing diabetes in the future (Huether & McCance, 2017).

Summary

            Diabetes is a common endocrine disorder affecting millions of Americans. Gestational diabetes affects a small percentage of pregnant women. Early diagnosis is imperative to prevent complications. Traditionally insulin was the drug of choice for treating GD, but recently Metformin has been used as an acceptable alternative. Adhering to a strict diet in combination with the pharmacologic interventions is critical to controlling GD.  

References

American Diabetes Association (ADA). (n.d.). Statistics about diabetes. Retrieved from https://www.diabetes.org/resources/statistics/statistics-about-diabetes

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: an introduction to clinical medicine (8th ed.). New York: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Elsevier.

MedlinePlus. (n.d.). Gestational diabetes diet. Retrieved from https://medlineplus.gov/ency/article/007430.htm

Rosenthal, L. D., & Burchum, J. R. (2018). Lehnes pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.