Gestational Diabetes
Gestational Diabetes Mellitus: an Overview
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy. Ninety percent of those diagnosed with diabetes during pregnancy will resolve after delivery (Scollan-Koliopoulos, Guadagno, & Walker, 2006). Pregnancy causes estrogen, progesterone and human placental lactogen to become elevated which provokes malfunctioning insulin, which can lead to insulin resistance and decreased cellular glucose uptake. The growing placenta causes the production of even more hormones, producing higher glucose levels and increased insulin resistance. When the pancreas can’t satisfy the demands for additional insulin, GDM results (Gattullo & Olubummo, 2009). Approximately 7%, or 200,000 pregnant women are diagnosed each year in the United States. Advanced maternal age, family history of diabetes, prior GDM, history of infant with macrosomia, and elevated BMI are all major risk factors for developing GDM. GDM is more often found in women of Asian, Hispanic or Native American descent (Cheng & Caughey, 2008).
GDM can have negative effects on both the fetus and the mother. These mothers experience an increased number of Caesarian deliveries and use of forceps or vacuum extractions, resulting in severe perineal lacerations, related to fetal macrosomia. Along with the risks associated with macrosomia, the mother is also at risk for developing hypertension and preeclampsia, leading to preterm labor, as well as, developing Type 2 diabetes after the birth of her baby (Cheng & Caughey, 2008). The increased amount of glucose in the gestational diabetic is correlated with macrosomia and childhood obesity (Scollan-Koliopoulos et al., 2006). Maternal hyperglycemia can increase the risk of hypoglycemia, respiratory distress syndrome, jaundice and hypocalcemia in the neonate. The negative effects of macrosomia include shoulder dystocia, brachial plexus injuries and
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy. Ninety percent of those diagnosed with diabetes during pregnancy will resolve after delivery (Scollan-Koliopoulos, Guadagno, & Walker, 2006). Pregnancy causes estrogen, progesterone and human placental lactogen to become elevated which provokes malfunctioning insulin, which can lead to insulin resistance and decreased cellular glucose uptake. The growing placenta causes the production of even more hormones, producing higher glucose levels and increased insulin resistance. When the pancreas can’t satisfy the demands for additional insulin, GDM results (Gattullo & Olubummo, 2009). Approximately 7%, or 200,000 pregnant women are diagnosed each year in the United States. Advanced maternal age, family history of diabetes, prior GDM, history of infant with macrosomia, and elevated BMI are all major risk factors for developing GDM. GDM is more often found in women of Asian, Hispanic or Native American descent (Cheng & Caughey, 2008).
GDM can have negative effects on both the fetus and the mother. These mothers experience an increased number of Caesarian deliveries and use of forceps or vacuum extractions, resulting in severe perineal lacerations, related to fetal macrosomia. Along with the risks associated with macrosomia, the mother is also at risk for developing hypertension and preeclampsia, leading to preterm labor, as well as, developing Type 2 diabetes after the birth of her baby (Cheng & Caughey, 2008). The increased amount of glucose in the gestational diabetic is correlated with macrosomia and childhood obesity (Scollan-Koliopoulos et al., 2006). Maternal hyperglycemia can increase the risk of hypoglycemia, respiratory distress syndrome, jaundice and hypocalcemia in the neonate. The negative effects of macrosomia include shoulder dystocia, brachial plexus injuries and
References: Cheng, Y., & Caughey, A. (2008). Gestational diabetes: diagnosis and management. Journal of Perinatology, 28(10), 657-664. doi:10.1038/jp.2008.62 Dawes, J Gattullo, B., & Olubummo, C. (2009). Sizing up gestational diabetes. Nursing, 39(12), 54-56. Retrieved from Academic Search Premier database. Hollander, M., Paarlberg, K., & Huisjes, A. (2007). Gestational diabetes: a review of the current literature and guidelines Klima, C., Norr, K., Vonderheid, S., & Handler, A. (2009). Introduction of CenteringPreg- nancy in a public health clinic. Journal Of Midwifery & Women 's Health, 54(1), 27-34. Retrieved from MEDLINE database. Scollan-Koliopoulos, M., Guadagno, S., & Walker, E. (2006). Gestational Diabetes Manage- ment: Guidelines to a Healthy Pregnancy. (Cover story). Nurse Practitioner, 31(6), 14-25. Retrieved from Academic Search Premier database. Serlin, D., & Lash, R. (2009). Diagnosis and management of gestational diabetes mellitus. American Family Physician, 80(1), 57-62. Retrieved from CINAHL with Full Text data base.