Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). INSTRUCTIONS: In your reply posts, use scholarly references and offer constructive feedback within
POST # 2 SYDNEY
Gestational Diabetes
The purpose of this post is to discuss the diagnosis and treatment of gestational diabetes, along with the pathophysiology and presenting symptoms. Gestational diabetes is a glucose intolerance in pregnancy when the woman was not previously diagnosed with diabetes (Plows et al., 2018). The authors state that gestational diabetes is caused by B-cell disfunction and insulin resistance in the tissue that progressively worsens in pregnancy. B-cells store insulin and secrete the insulin in response to the glucose level in the body. Pregnancy can cause changes that can create a decrease in insulin sensitivity. The insulin sensitivity can be decreased because of higher levels of estrogen and cortisol made in the placenta. Gestational diabetes occurs when the woman cannot create a sufficient response to the normal resistance of insulin in pregnancy (Kampmann et al., 2015). The mother then transfers the glucose to the placenta. The fetus creates hyperinsulinemia to counter the excess of glucose in the placenta. The high levels of insulin in the fetus allow for the fetus to grow larger than a normal fetus (2015).
According to the CDC, gestational diabetes does not typically have any symptoms. The patient could have certain risk factors that make them more susceptible to get gestational diabetes. These risk factors include being overweight, having gestational diabetes in a previous pregnancy, older than 25 years old, and have a family history of type two diabetes (CDC, 2020). Women who have a family history of diabetes should have their glucose monitored closely throughout their pregnancy (Hubert & Vanmenter, 2018). Gestational diabetes can be detected between the 24th and 28th week of pregnancy. The patient drinks a liquid that contains glucose, and the blood sugar is checked one hour later (CDC, 2020). The patient passes the glucose test if the blood sugar is 140 or lower. If the patient does not pass the one-hour glucose test, the patient will have a glucose tolerance test. The glucose tolerance test measures a fasting blood sugar on the patient before the test. Once the patient drinks the glucose, the blood sugar is tested every hour for three hours (CDC, 2020). The patient can be determined to have gestational diabetes if they do not pass the three-hour glucose test.
Gestational diabetes cannot be cured until the patient delivers the infant, but it can be managed. The standard treatment for gestational diabetes is diet, glucose monitoring and insulin. The patient can typically control their blood sugar with diet and some exercise (Kampmann et al., 2015). It is important for the healthcare provider to provide guidance on the proper diet to control the patient’s blood sugar. Physical activity is important to manage gestational diabetes because it lowers the blood sugar and makes the body more sensitive to insulin, so it will not require as much (CDC, 2020). The patient can continue to monitor glucose closely to make sure that the diet and exercise are controlling the blood glucose levels. If the patient is having trouble maintaining their blood glucose levels, the patient can be started on insulin for better control. The baby will also be monitored closely by the healthcare provider to watch for macrosomia and ensure that the baby is healthy throughout the pregnancy.
This link provides a detailed treatment guide: https://www.diabetes.org/diabetes/gestational-diabetes/how-to-treat-gestational-diabetes
This link provides a detailed treatment guide: https://www.cdc.gov/diabetes/basics/gestational.html
References
Centers for Disease Control and Prevention. (2020). Diabetes tests. Retrieved from https://www.cdc.gov/diabetes/basics/getting-tested.html
Hubert, R. J. & VanMeter, K. C. (2018). Gould's pathophysiology for the health professions. St. Louis, MO: Elsevier Saunders.
Kampmann, U., Madsen, L. R., Skajaa, G., Iversen, D. S., Moeller, N., & Ovesen, P. (2017). Gestational diabetes: a clinical update. Retrieved from 10.4239/wjd.v6.i8.1065
Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The pathophysiology of gestational diabetes mellitus. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274679/pdf/ijms-19-03342.pdf
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