Introduction
The online peer discussion has enhanced my internalization on the implications of Gestational Diabetes Mellitus (GDM), specifically in the context of NSW Australia. The online posts and peer discussion enabled me to gain insight as we were engaged in exchange of significant ideas on the topic under discussion. The contributions from each group member summed up to the development of the briefing document.
Gestational Diabetes Mellitus
The contributions from group members gave me a clear picture of GDM as a chronic disease, and the issues surrounding it. I gained the understanding that GDM is the disorder of carbohydrate intolerance mostly diagnosed in women who are expectant. During pregnancy, the body’s glucose metabolism is affected by the progesterone that is produced by cortisol, prolactin and the placenta. This interference is the main contributor to GDM. The demand of insulin in the body during pregnancy often increases starting from the second trimester. Given that most of the expectant women experience inadequate production of insulin, they often get hyperglycaemia as the growth and development of the foetus relies on the blood glucose. Conversely, high perinatal morbidity is associated with GDM. The condition is noted as a common complication that stems from GDM and its development corresponds to the development of pregnancy.
Gestational Diabetes Mellitus in the Context of NSW Australia
The group members’ contributions expanded my understanding of GDM in the context of Australia. GDM is prevalent in NSW Australia and its figures hit 4.7% in 2005. The group of women who are at a higher risk of infection are the indigenous women of which NSW makes about 8% of the total population.
The Implications of Gestational Diabetes Mellitus
With regard to this topic, the critical aspect is the fatal nature of GDM. It can possibly result in diabetes, which is a chronic disease. This leads to the risk of people developing multi-organ diseases. We had a deeper evaluation of the implications of GDM and we cited the inadequacy of resources and technology as the contributors of GDM. We all agreed that the nature of GDM calls for specialised care, which has not been realised much in the case of NSW Australia. Geographical isolation has contributed to the complexity of GDM, given that regional centres are far away from the remote communities. Expertise and medical equipment and supplies are among the inadequacies.
Prevention and Management of Chronic Disease Course
The online posts and peer discussion intensified our concern for the disorder, and we explored the current measures being employed in NSW Australia. Glucose monitoring through screening and management of the disease through patient education has been employed in NSW. Given that these initiatives have expanded the women’s understanding of GDM, we resorted to expound on patient education as it is the most successful approach. We decided to raise the awareness of GDM amongst midwifes, GPs, partners, patients and the public at large. This is a step seeking to reduce the chances of people developing type 2 diabetes and neonatal morbidity in WNSWLHD. I personally took the task of exploring the best prevention and management measures of GDM. I identified that universal screening should be done at intervals of 26-28 weeks with a 50g glucose load. In cases where the outcome turns out as positive, a glucose load of 75g OGTT should be administered. More so, women living in isolated areas should have better access to antenatal care. This should be the responsibility of telehealth consultants. The antenatal care team has to be supplied with additional aboriginal health workers to enhance support for the indigenous women during pregnancy. Furthermore, it is significant to have a better control of glycaemia so as to prevent neonatal morbidity. This implies that telehealth should monitor BGLs/ adequacy of diet regularly. Women who develop GDM should be subjected to OGTT within 6-8 weeks of post delivery. Additionally, they should be issued with letters informing them of the implications of GDM with regard to type 2 diabetes, and the significance of having OGTT. Reminder letters should be sent to patients in a bid to reinforce the significance of further testing. Distribution of brochures about GDM should also be included in obstetric practices, antenatal clinics and GP practices within WNSWLHD via the Division of General Practice.