Introduction
A pregnant woman can have gestational diabetes where tests find a level of glucose intolerance on first recognition. GDM is commonly diagnosed during pregnancy. Studies have found that approximately 7 percent of all pregnancies have GDM complication, and the prevalence is estimated between 2%-14% (American Diabetes Association, 2004). The changes in rates are mostly attributed to the number of contradictory criteria used in the diagnosis, even those guidelines provided by the American Diabetes Association and the World Health Organization.
Gestational diabetes starts when the woman is pregnant. Insulin injection may be recommended although the sickness may prevail after delivery. Proper care is given when there is sign of insulin intolerance.
Assessment of GDM
The first part of the assessment process is the testing of blood glucose. Important information in the assessment includes individual maternal characteristics, behaviors, and experiences occurring several months prior to conception, during pregnancy, and the time following delivery. Information on lifestyle factors is significant in the assessment and data gathering.
Risk factors to be determined include body mass index, ethnicity, and maternal age evaluated using logistic regression. Obesity or overweight increases the risk for GDM. Ethnicity and advanced mother’s age are also factors in having GDM. These cannot be modified, thus the mother has to be educated of these risks.
When diagnosed with GDM, she will be oriented of her condition, educated of lifestyle changes and treatment to be given. Initially, she will have to attend a wellness module for women with GDM – the Care for Women Diagnosed with GDM. This is a twice-a-week program designed to care for pregnant women who may have other important schedules to attend to. Women will be taught how to take care of themselves and how to adjust to the treatment process. Pregnant women who are of advanced age and/or belong to ethnic groups are properly screened and monitored by health professionals.
Another important activity is the Post-partum gestational diabetes care. This is provided for pregnant mothers who have just been diagnosed with GDM. This module will not only focus on the mother, but on the baby as well. This time in a mother’s life is stressful and can increase glucose levels. New mothers are encouraged not to skip this important part of the treatment process.
Recommendations
Institutions like the Agency for Health Research and Quality (AHRQ), The Family Practice Therapeutic Guidelines, the ADA, and other government and private institutions make recommendations for GDM postpartum care. The AHRQ recommends: reclassification of maternal glycemic status in first six weeks after delivery, physical exercise for the mother, patient education regarding the required body weight, avoidance of insulin-resistant drugs, family planning methods and education, and assessment of offspring to find out abnormalities of glucose tolerance.
The Therapeutic Guidelines for Family Physicians provide recommendations for blood glucose measurement six weeks after delivery. This should be taken on two occasions to determine glucose tolerance and its classification, whether it is normal, impaired glucose tolerance, or diabetic. Normal glucose will provide a test value of less than 140 mg per dl. Impaired glucose tolerance may be above that, e.g. 140-200 mg per dl. Another recommendation is the regular annual screening for diabetes after a GDM pregnancy. Patients are advised to change lifestyles following a GDM pregnancy, and to observe a nutritional diet of fresh fruits and vegetables and regular exercise.
References
American Diabetes Association. (2016). Gestational Diabetes. Web.