Gestational Diabetes Assignment

Mareba St Bernard

Liberty University

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Abstract

Glucose, often known as sugar, is the principal source of energy required by human cells

and the body to function correctly. The pancreas produces insulin, which permits cells in the

muscles, liver, and adipose tissue to take in sugar or glucose and break it down to make ATP,

which is used as energy. Insulin also aids in storing extra glucose in the liver and muscle cells in

an inactivated state known as glycogen, which is then utilized as needed. Diabetes is a disorder

that affects how the body uses blood sugar (glucose). Glucose is a type of sugar that comes from

the food we eat. It is the primary source of energy for our bodies.1 Diabetes can cause serious

health problems, including heart disease, blindness, kidney failure, and lower-extremity

amputations. There are three types of diabetes: Type 1 diabetes (an autoimmune disease in which

the body's immune system attacks and destroys the cells in the pancreas that produce insulin),

Type 2 diabetes (when the body cannot use insulin properly or when the pancreas does not make

enough insulin), and Gestational diabetes.2 This paper discusses Gestational diabetes, its

implication, management, prevalence, and Biblical worldview influences.

Physiology of Gestational Diabetes

Gestational diabetes is a type of diabetes that affects pregnant women. It usually goes

away after the baby is born, but some women develop type 2 diabetes later in life. Gestational

diabetes occurs when the body cannot make enough insulin to meet the extra demands of

pregnancy. There are usually no apparent symptoms of gestational diabetes. However, many

warning signs for gestational diabetes include frequent urination, sugar in urine, fatigue, nausea,

unexplained weight loss, blurred vision, unusual thirst, and vaginal, skin, or bladder-related

infections.3 A few things can increase a pregnant woman's risk of developing Gestational

Diabetes. These include having a family history of diabetes, health conditions such as high blood
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pressure and diabetes type II, lifestyle problems such as low physical activity, sedentary lifestyle,

being overweight or obese, having had Gestational Diabetes in a previous pregnancy, and

belonging to certain ethnic groups (such as Hispanic, African American, Native American, or

Asian American). If left untreated, gestational diabetes can cause severe problems for both

mother and baby, including macrosomia (a large baby), which can lead to birth trauma or

cesarean delivery, pre-eclampsia (high blood pressure and protein in the urine), which can be

life-threatening, stillbirth or neonatal death, and type 2 diabetes later in life for both mother and

child.3

Social, Emotional, and Economic Implications of Gestational Diabetes

Gestational diabetes does not only have a physiological impact on the patient; instead it

also causes significant social, emotional, and economic implications among women. For

example, in terms of social implications, pregnant females with gestational diabetes may feel

self-conscious and judged about their weight gain and the fact that they have GD which may

pose a threat to a fetus's life. Pregnant females with gestational diabetes may feel like they are

unable to participate in normal activities because of their condition. This return may lead to a

lack of social support for pregnant females with GD.

Pregnant women go through a roller coaster of emotions throughout the gestation period

and after birth. The emotional implication increases multiple folds if the pregnant woman has

gestational diabetes. For example, pregnant women with gestational diabetes may experience

fear, depression, and anxiety due to the potential complications associated with the condition, not

only regarding their own health and the well-being of their child. Lastly, economically, GD may

also increase burdens on the women or their families, pregnant women with gestational diabetes

often require close monitoring by their healthcare team.4 Additionally, in unfortunate instances,
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if the newborn child or mother (after birth) suffers from a health condition, the medical expenses

may go up exponentially.

Management of Gestational Diabetes Medically and Nutritionally

The front-line treatment for gestational diabetes is primarily based on pharmacological therapy

and diet, behavioral, and lifestyle changes. Many pregnant females suffering from gestational

diabetes are recommended the injection of insulin. These insulin regimens may include

intermediate-acting insulins and short-acting insulins such as isophane (NPH), and regular

recombinant insulin (Humulin R), respectively.5 In addition, diet, behavioral, and lifestyle

changes include whole fruits and vegetables, lean proteins, healthy fats, whole grains (moderate

amount) food items, and avoiding fast food, sugary drinks, fried food, alcohol, and cigarette

consumption. Furthermore, exercises such as aerobic exercise, pelvic tilts, kegel exercise,

walking, etc. for around 15-60 minutes per day are also recommended to pregnant females in

order to reduce the possible pre-birth and after-birth complications.6

Gestational Diabetes in Developing Countries

Gestational diabetes is a global problem, and it has been estimated that GDM affects up to 7–

10% of pregnant women worldwide. The vast majority of cases occur in low- and middle-income

countries. Nearly two-thirds of all cases occur in Africa and Asia. Data indicate that GD

complicates approximately 5% to 7% of pregnancies, which leads to pregnancy and lead health

problems for both the mother and the child. 7 In some cases, it can even be life-threatening This

is likely due to the prevalence of a combination of risk factors in the population, including poor

diet, lack of exercise, and high rates of obesity.7 India is one the countries with the highest

prevalence and hence is considered a primary concern for pregnant women. Based on the current

literature, it is estimated that gestational diabetes mellitus impacts around 5 million women in
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India every year. In addition, out of 6 million births affected by diabetes every year, gestational

diabetes accounts for more than 90 percent of the cases.8 In A cross-sectional study consisting of

32,428 pregnant women, the age range with the highest number of gestational diabetes was

between 15 to 49 years. However, the trend also demonstrated that the risk of gestational

diabetes increased with age at the rate of 1% from 15 – 19, whereas 2.4% from the age 35 and

above.9 The most observed outcomes of gestational diabetes observed in both mother and child

included preterm labor, increased number of cesarean delivery cases, imbalanced sugar levels,

high blood pressure, and vaginal infections. The study also suggested that gestational diabetes

also posed an increased threat of developing obesity, diabetes type II, and other chronic diseases

in the later stages of the child.9

Gestational Diabetes Statistics for United States vs India

Gestational diabetes is considered a serious condition in the United States, same as in India, that

can have multiple significant implications for both the mother and child. The prevalence of

gestational diabetes has been increasing in recent years. According to the US Centers for Disease

Control and Prevention (CDC), based on the trends of recent years, around 2% to 10% of

pregnancies are affected by gestational diabetes mellitus.10 In terms of age, the trends are far

from similar in the case of the United States as compared to India, primarily due to the

differences in the average age of women getting married in both countries. The mean or average

age for pregnant women to acquire gestational diabetes mellitus in the United States is 30 ± 5.96

years, and the prevalence is the highest for the age group ≥35 years which is 18.3%. The major

outcomes in the United States due to gestational diabetes for babies are increased chances of

surgical delivery (C-section), stillbirth, or premature birth; however, in 80% of cases, gestational

diabetes goes away after the birth. 10 Nonetheless, it may pose similar threats to the child in the
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future, such as the development of type II diabetes, high blood pressure, etc. later in their life.

Another major difference between the prevalence of GDM in the US and India can be observed

in terms of race and ethnicity. In the US, GDM is more prevalent in racial and ethnic minorities,

such as Asian (specifically South Asian), African American, American Indian, and Hispanic

women, as compared to non-Hispanic White American women.10

Barriers Faced by Women in Developing Countries Vs. Developed Countries

There are a number of barriers to the effective management of gestational diabetes. These

barriers can be found in both developed and developing countries, however, the difference may

lie in the prevalence of the barriers. For example, in developing countries, major barriers to the

management of gestational diabetes include a lack of awareness as many people in developing

countries are not aware of the importance of good health and do not seek out healthcare services,

insufficient financial and human resources and poor access to healthcare. In many parts of the

world, people do not have access to quality healthcare. This can make it difficult to get timely

diagnosis and treatment. Likewise, poverty and social stigma can make it hard for people to seek

help and support. 11 On the other hand, in developed countries, barriers may include insufficient

insurance coverage, healthcare staff shortages, racial discrimination or biases among the medical

community, transportation or work-related barriers, and patient language barriers.12 However,

many of these barriers overlap and are found in the management of gestational diabetes

irrespective of the status of the countries (that are developed and developing).

Suggestions for Overcoming Barriers

The importance of overcoming barriers to health care cannot be overstated. It is important to

overcome these barriers to healthcare in order to improve the health of populations around the
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world. Gestational diabetes is a serious condition that can have long-term consequences for both

mother and child. With proper treatment, however, many of these complications can be avoided.

In the case of developing countries, these barriers can be removed by improving access to quality

healthcare and increasing awareness about the importance of good health and available

healthcare services. This can be done by increasing funding for healthcare, training more

healthcare workers, and constructing more hospitals and clinics. Similarly, reducing poverty

through economic development and social welfare programs and breaking the social stigma

through education and public awareness campaigns can also be efficient ways to remove barriers

to the effective management of GDM.

On the flip side, in developed countries such as the US, by increasing insurance coverage

through programs such as Medicaid, Medicare, and private insurance companies by negotiating

better reimbursement rates and increasing benefits can significantly reduce barriers in the way of

management of GDM. In addition, encouraging early diagnosis and treatment by providing free

or low-cost screening tests and making treatment more accessible, and increasing awareness

about the condition through public education campaigns and doctor outreach programs can also

be done to eliminate barriers and increase the access of pregnant females suffering from GDM to

attain professional healthcare.

Biblical Worldview Influences

The Bible does not specifically mention gestational diabetes. However, it talks about the

importance of maintaining good health and taking care of our bodies and maintaining good

health. In 1 Corinthians 6:19-20, “Do you not know that your body is a temple of the Holy Spirit,

who is in you, whom you have received from God? You are not your own; you were bought at a
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price. Therefore honor God with your body.”13 This means eating a healthy diet, exercising

regularly, and getting timely medical care when needed. In my opinion, it is our social, moral,

and religious responsibility to protect both mother and the child from any adverse impacts of the

GDM. In addition, we, as the public, should join hands with healthcare and welfare

organizations, and governments to reduce the barriers to healthcare access, spread the knowledge

about the risk factors, and break down the social stigma.
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