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Gestational Diabetes Essay

869 words - 4 pages

In the United States the occurrence of diabetes is increasing, and frequently diagnosed in women of childbearing age (Mokdad AH, Ford ES, & Bowman BA, 2001). At an estimate of 1.85 million women of childbearing age have gestational diabetes, and about a third of this number are still undiagnosed. Yearly, approximately 3%-8% of all pregnant women develop gestational diabetes (Diabetes Care 2005;28:579). The definition of Gestational Diabetes Mellitus is the intolerance to glucose or carbohydrates, which is estimated to be approximately 90% of intolerance to glucose during pregnancy (Diabetes Care 2005;28:579).
The definition of Gestational Diabetes Mellitus is the intolerance to glucose or ...view middle of the document...

Published Guidelines
There are some physiological measures that can be used such as 2hr and 3hr blood glucose levels after oral glucose tolerance test, and fasting blood glucose levels. This test is to be done around 24-28 weeks of gestation and is supported by ACOG. After diagnosis of gestational diabetes is made, dietary counseling should be done, monitoring of blood glucose levels, and mild physical activity is required to make sure that glycemic control is achieved. When the recommended target blood glucose levels are not achieved with diet and nutrition the next step is the introduction of pharmacological agents such as insulin and oral medications. It has been found beneficial to randomly test and monitor for gestational diabetes for better management and outcomes. Current ADA and ACOG guidelines recommend to do modify diet which is also referred as medical nutritional therapy and are based on the patient’s choice and cultural needs, as well as counting carbohydrates, in between-meals snacks. These modifications are also made based on the amount of weight needed to be gained or lost. Fetal monitoring is also done during pregnancy, including screening for fetal anomalies, growth and wellbeing. Monitoring of A1C level , elevated fasting blood glucose level higher than 120mg/dL, previous hyperglycemia and a diagnosis of GDM in the first trimester of pregnancy will encourage providers to screen for fetal malformation. Bi-weekly antenatal visits are encouraged for non-stress tests and biophysical profile (BPP) and to see if the type of therapy received is working.
Clinical Pathways
Clinical pathways provide specific path for the care needed to meet the needs of specific problems, including the sequence and timing in which they will occur. Pathways lay out the nursing...

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