Gestational Diabetes in pregnancy (Essay Sample)

Gestational Diabetes in Pregnancy
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Gestational Diabetes in Pregnancy
Introduction
In recent decades, there has been an increased prevalence of diabetes globally, affecting individuals from diverse age groups and social contexts. According to available statistics, it is estimated that over 460 million people will be diagnosed with diabetes by 2030. In the past, diabetes development was most common among the elderly members of society; however, in recent years, diabetes is affecting young adults and children. One social group at growing risk of developing diabetes includes women of child-bearing age leading to gestational diabetes mellitus (GDM). GDM is defined as a glucose intolerance common among pregnant women and is associated with complications during pregnancy and childbirth. In addition, the diagnosis of GDM is considered to be a manifestation of type II diabetes later.
Gestational diabetes is a prevalent disorder in the United States and Globally. However, there exists little emphasis from the academic scope on the prevalence and possible effects of the disorder in society. This essay seeks to analyze an overshadowed disorder facing a number of women by first considering the characteristics of the affected population, the prevalence of the diseases, and secondary prevention mechanisms to incorporate based on the clinical context.
Specific Population Group
Working in a federally funded OB/GYN clinical setting as a nursing practitioner, the majority of patients I serve are women of child-bearing age who have experienced challenges resulting from gestational diabetes. A majority of the patients are between the ages of 15- 51 years, pregnant, and experiencing complications with their pregnancies. Following appointments from their gynecologists, all women undergo an OGTT test between the 24-28 weeks of pregnancy to determine blood glucose levels.
Patients categorized as at a higher risk of gestational diabetes may be required to undergo OGTT at any moment of the pregnancy. In most cases, individuals with higher blood sugar levels are diagnosed with gestational diabetes mellitus. Women diagnosed with GDM included individuals pre-diagnosed with type II diabetes, obese patients, and patients with a family history of diabetes.
Identified Population of Interest
Gestational diabetes mellitus is categorized among the most common metabolic disorders among women globally. The estimated prevalence of GDM varies based on study contexts, with some studies estimating global GDM prevalence to categorize between 1 to 45 percent of all pregnancies. In a study conducted by Lawrence et al. (2019), GDM was estimated to affect between 7-10 percent of all pregnancies worldwide. The estimation of the prevalence of GDM prevalence rates is difficult due to differences in risk factors. On the other hand, GDM prevalence was estimated to be higher among residents of Vietnam, Singapore, China, and Malaysia (Lawrence et al., 2019).
Available data from CDC. Gov (2019) estimates that about 1 -2 percent of all pregnant women have been diagnosed with either type 1 or type 2 diabetes. In addition, roughly 6-9 percent of pregnant women are diagnosed with gestational diabetes. Gestational diabetes has been said to predispose a baby to congenital disabilities, stillbirth, and preterm birth. Moreover, high blood sugar during pregnancy may also result in increased risks for women leading to the need for cesarean delivery. CDC. Gov (2019) further notes that between 2-10 percent of all pregnancies in the United States are affected by gestational diabetes each year.
Research conducted by the Texas Health Care Information Collection (THCIC) estimated diabetes rates to be 6 percent of the total population in Texas. America’s Health Rankings (2020) further notes that the study concluded that over 9 percent of pregnant women in Texas experienced GDM. It is essential to acknowledge that these rates were calculated based on available data from insurances such as Medicaid and did not factor in rates for women who made cash payments. A majority of research has associated the rise in GDM with increased diabetes rates in the population over the years. Consequently, it is crucial to analyze the diabetes rates in the United States.
According to CDC. Gov (2020) estimated that a total of 10.2 percent of the total population in the United States had been diagnosed with diabetes based on data available between 2013 and 2016. Further, 3% of individuals between 18 and 44 years and 13.8 percent of individuals between 45 and 64 have been diagnosed with diabetes. CDC. Gov (2020) notes that 21.5 percent of individuals above 65 years have been diagnosed with the disease. The research further indicates that 2.8 percent of the total population suffers from diabetes; however, their conditions are yet to be diagnosed. The undiagnosed diabetes phase includes 1% of individuals between 18-44, 3.6 percent of individuals between 45-64 years, and 5.4% of adults above 65. In addition, diabetes prevalence is higher among men than women, with 14% of all men having diabetes compared to 12% of the women population (CDC. Gov, 2020).
Diabetes prevalence also varied based on race and ethnicity. Zhou et al. (2018) explain that 11.9% of the white, non-Hispanic population suffer from diabetes, which is relatively lower compared to the 16.4% diabetes prevalence rate evident among the black, non-Hispanic population. Casagrande et al. (2018) note that 14.9% of the Asian, Non-Hispanic community is also estimated to suffer from diabetes, while14.7% of the Hispanic population also suffer from diabetes. NIH.gov (2021) notes that age-adjusted estimates of diagnosed diabetes based on race and ethnicity indicated that diabetes prevalence was highest among American Indians and Alaska Natives. These prevalence rates were also higher for women to men at rates of 14.4 and 14.0 percent, respectively.
NIH.gov (2021) explains that these age-adjusted estimates further showed that diabetes was high among Asian, Non-Hispanic populations at an 8.2 percent prevalence rate. Diabetes rates among black, non-Hispanic women population was at 11.1%, while prevalence rates for Hispanic women population were at 10.6%. The lowest diabetic rates experienced were at 5% for white, non-Hispanic populations. NIH.gov (2021) further notes that over 47.1 million women in the United States were estimated to present prediabetes characteristics based on a survey conducted in 2018. These estimates indicated a 51 percent rise in prediabetes rates compared to estimates between 2013 and 2016. It is crucial to acknowledge that the prediabetes and diabetes rates within the United States present an enormous relationship to the development and occurrences of gestational diabetes among women of child-bearing age.
In addition to the prevalence rates of diabetes and prediabetes among women of child-bearing age, the BMI index served as a critical characteristic in gestation diabetes mellitus. Melchior et al. (2017) acknowledge that a comparison in weighted BMI categories among women between the ages of 20-44 indicated numerous disparities associated with increased rates of GDM. Melchior et al. (2017) hence acknowledged that obese rates between 1976 and 1980 averaged 12.1 kg/m2. These rates significantly differed from similarly obese measurements taken between 2007 and 2010, which averaged 32.7 kg/m2. It is crucial to acknowledge that Obese rates were considered to be high when they exceeded 30.0 kg/m2.
Based on these inferences, it was evident that obesity rates were highest over recent years compared to the past. Second, overweight rates between 1976-1980 were estimated to be at 21.6 kg/m2, while rates between 2007-2010 were measured as 26.4 kg/m2 exceeding normal rates. The changes in BMI measures among women were associated with lifestyle changes and lack of physical exercise.
Health Issue
According to Plows et al. (2018), there exists an inadequacy in statistical information relating to gestational diabetes during pregnancy in the country. This inadequacy can be associated with a range of reasons; however, the predominant cause is associated with increased research on general diabetes, paying little focus on GDM. First and foremost, available research from NIH.gov (2021) indicates that over 6 percent of US women who conceived in 2016 suffered from gestational diabetes. Fifty percent of these US women diagnosed with gestational diabetes were later diagnosed with type 2 diabetes. These statistics may be considered to be inconclusive for diverse reasons. Firstly, the data failed to indicate the percentage of women diagnosed with gestational diabetes and experienced challenges such as stillbirths during their pregnancies. Second, it failed to include statistics on women undiagnosed with gestational diabetes during their pregnancies.
Globally, an estimated 223 million women between the ages of 20-79 are living with prediabetes. These numbers are expected to grow over recent decades with an estimated projection increase of 20 percent by 2030. In addition, 20 million live births globally have been associated with hyperglycemia during pregnancy. NIH.gov (2021) explains that an estimated 84 percent of these births were a result of GDM. Every 1 in six births globally are affected by gestational diabetes; however, these statistics fail to account for loses of the fetus before birth due to complications arising from GDM. The average prevalence of gestational diabetes conducted in 23 states was estimated to be 5.32 percent, with the highest rates evident among Asians, His...