Gestational Diabetes Project

This project examines gestational diabetes (GD) in pregnancy, exploring its prevalence, causes, effects on both mother and child, and the best methods for diagnosis and prevention. It utilizes a qualitative research methodology, including interpretative philosophy, primary data collection, random sampling, and thematic analysis. The project also includes a comprehensive literature review, highlighting the latest research findings and expert opinions on GD.

GESTATIONAL DIABETES/DIABETES
IN PREGNANCY

TABLE OF CONTENTS
PROPOSAL.....................................................................................................................................1
Background of the study.............................................................................................................1
Aim and objectives......................................................................................................................4
Research specifications...............................................................................................................5
Literature review.........................................................................................................................6
Rationale.....................................................................................................................................7
Significance.................................................................................................................................7
Research plan..............................................................................................................................8

PROPOSAL
Background of the study
Gestational diabetes occurs to pregnant women. This is a disease which women can have
at the time of their pregnancy. In this disease, at the time of pregnancy, the sugar level of glucose
rises in women and takes the form of gestational diabetes (What is gestational diabetes, 2016).
Around 9850 pregnant women will be screened for GD. This is a condition in which women
without diabetes develops a high blood sugar at the time of pregnancy. This causes due to not
having enough insulin due to insulin resistance. This is a problem where there is way too much
sugar in blood. This generally arises in third trimester (after 28 weeks) and goes after the baby is
born. Therefore, pregnant women develop type 2 diabetic issues later in life. Its symptoms are
very mild such as blurred vision, fatigue, often occurrence of infection in wound area, skin and
vagina. Therefore, it also includes weight problems, genealogy of diabetes, extreme level of
amniotic liquid, hypertension etc. Many communicate about ways to confront gestational
diabetes mellitus to assure that they can have a healthy and balanced pregnancy as well as
parturition, yet basically gestational diabetic issues can occur. According to the analysis by the
research centres, it has been found that every second woman suffer from gestational diabetes
(Alfadhli, 2015).
The root cause behind this is still unknown. Some clues were founded by doctors and
gynaecologists. Baby is supported by placenta as it grows, where hormones from the placenta
helps in the overall development. But sometimes, these hormones restrict the action of insulin in
mother's body. And this problem is known as insulin resistance.
This problem starts when the body is not able to make and use insulin, which is required
during pregnancy. Without enough insulin, glucose cannot enter the blood system and converted
into energy. This is usually diagnosed during late pregnancy. If one is diagnosed with diabetes
earlier in pregnancy, then it may have diabetes before pregnancy only (Spaight and et.al., 2016).
Treatment of gestational diabetes can help both mother and son in staying healthy.
Chances of getting Gestational Diabetes are very high. It is caused due to Overweight,
hereditary issue, takes place if any family member in blood relation is suffering from type 2 or
any other kind or if any one suffering from pre-diabetes. Therefore, if mother gives birth to a
baby who is more than 9 pounds, then there are also chances of an increment in gestational
diabetes level. Women with hormonal disorder faces problem and it definitely influence the
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baby’s overall growth with few risks to considered at delivery time. Doctors with the help of
blood test diagnosed this disease (Koivusalo and et. al., 2015).
Gestational diabetes has some ethnic groups at a higher risk in developing this type of
diabetes including Afro-American, Asian American, Hispanics, native Americans, pacific
islanders. The best way to cure this disease is lowering the risk factors of gestational diabetes to
be healthy and prepare the body for pregnancy. Intake of fruits and green vegetables helps to
overcome gestational diabetes in women (DeSisto, Kim and Sharma, 2014). The symptoms of
gestational diabetes include fatigue, excessive thirst, increase of urinary urgency and frequency,
snoring, over weight etc. If one is suffering from gestational diabetes, they must avoid the intake
of carbohydrates, alcohol, processed foods and food containing starch. There are some activities
which should be performed during pregnancy to avoid gestational diabetes such as Pilates, yoga,
walking, swimming, running, weight training etc.
Doctors takes blood sample from women body and send it laboratory for testing. This test
must be done during starting months of pregnancy. After collecting sample, screening for
glucose challenge test should be conducted. In this test, women should drink sugary beverages
and have blood sugar level checked an hour later (Krejčí, 2016). If results are not normal, then
women should go for oral glucose tolerance test. In this test women should have to do fast for at
least hours before the test.
This provide inverse effects on baby. As if mother has gestational diabetes and is not
under control then the child also has chances of high blood glucose in the body. This will result
on baby’s pancreas to make extra insulin to control high blood glucose (Leng and et.al., 2015).
This extra insulin turns into excess fat. If gestational diabetes does not get properly treated, it
might cause problems to baby, such a larger body than normal, and this condition is called as
Macrosomnia. It is a disease in which baby starts growing faster and hence results into a larger
size than the normal one, which also makes delivery difficult and cause danger to baby. Right
after birth, baby can suffer with low blood glucose (hypoglycaemia). Further, child could face
problems like respiratory distress syndrome, breathing problems and sometimes can cause death
soon after birth.
Gestational diabetes goes away once mother gives birth. Doctors will recommend to have
check-up for 6-12 weeks. If gestational diabetes has gone, then it may be possible that it will
give birth to type 2 diabetes (Pantham, Aye and Powell, 2015).
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Therefore, baby could also suffer with jaundice, which is very common in new-borns to
mother who had diabetes while pregnancy. Symptoms of jaundice is skin as well as white portion
of an eye (sclera) turning into yellow (Who's at risk of gestational diabetes, 2015). It usually
goes away but requires special treatment. Along with, infant must get lots of milk from
breastfeeding to make sure that jaundice goes away (Victor and et.al., 2018).
If mother is suffering from gestational, doctors recommend some extra test like
ultrasound exam which shows health of baby, whether baby is larger than normal; non-stress test,
which is used to identify increase in heart rate which shows that baby is active or not. On the
other hand, mother also get affected as it increases chances of high BP and presence of too much
protein in urine, which is also called pre-eclampsia. Depression and type 2 diabetes comes with
gestational diabetes (Sebastiani and et.al., 2017).
Gestational diabetes can be treated with the means of keeping blood glucose levels in a
targeted range. It could be prevented by healthy eating, physical activities and consider insulin
shot if required.
Present survey is based on evaluation of mother and child outcomes from diabetes. This
has been done to find out various causes and their results regarding this type disease. It will also
discuss about frequency of occurrence of various maternal and fetal results among gestational
diabetes patients. It will likewise determine different reasons of GD and its effects on both, child
and mother. Researcher will cover screening method to diagnose this type of diabetes and also
find out the best ways of curing it for them. To identify the outcomes of gestational diabetes,
researcher will use various techniques of research methodology which involves interpretative
philosophy, data collection, random sampling methods and thematic analysis. Furthermore,
researcher will conduct a literature review to identify views of different authors. This will
provide rationale, significance and research plan for the research.
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Illustration 1: Gestational Diabetes
(Source: Gestational Diabetes, 2014)
Aim and objectives
Aim
To evaluate maternal and neonatal management outcomes of diabetes/gestational diabetes
in pregnancy
Objectives
 To study frequency of occurrence of various maternal and fetal outcomes among
gestational diabetes patients.
 To identify various causes of this type of diabetes and its effects on child and mother.
 To discuss screening method to diagnose gestational diabetes
 To find out the best methods to protect women from gestational diabetes.
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Research questions
 What is occurrence of various maternal and fetal outcomes among gestational diabetic
patients?
 What are various causes of gestational diabetes and its effects on child and mother?
 What are screening methods to diagnose gestational diabetes?
 What are the best methods to protect women from gestational diabetes?
 What research has guided these changes?
 What are the implications of these changes?
Research specifications
Research methodology is a particular process used to determine, select, process, and
examine subject matter about a topic. Methodology part of research paper permits readers to
critically evaluate study's overall validity and reliability (Tobias and et.al., 2018).
Present study is about Gestational diabetes. It has been done to evaluate maternal and
neonatal management outcomes of diabetes. For specific research, methods like interpretative
philosophy will be included which involve various theories and models of research. For data
collection, primary data collection source must be considered. Apart from that, the research will
take random sampling technique and thematic analysis method. This study will take support of
Interpretative philosophy, which assumes that people create and associate their own subjective
and intersubjective meanings while they interact it with the world or surroundings around them.
This inquiry includes various models and theories of researches in identifying objectives of
research (Waters and et.al., 2018). It will prove beneficial as it is a qualitative research so it can
be studied with great level of depth; it will also help in primary data generation.
The source of data collection will be primary data, in which researcher collects it for the
very first time. This gives the most reliable and fresh data to investigator about the respondents.
This source will be beneficial as information driven by primary data collection is relevant to the
topic, so the degree of accuracy will be high. The data will provide a realistic view to researcher
for the topic under consideration (What is gestational diabetes., 2016).
For this particular research, the researcher will take simple random sampling method
where every sample has equal probability of being selected. It is an unbiased representation of
total population. Under random sampling, each member of the subset carries an equal
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opportunity of being chosen as a part of this process. For this research, it will be beneficial
because it provides a better chance to represent the whole population.
Thematic analysis is the most common form of analysis in qualitative research in
identifying patterned meaning across a dataset (Who's at risk of gestational diabetes, 2015).
Literature review
As per the view of Kim, (2014) argued that the reason behind this disease is lack of
insulin in mother’s body. As per view of Alfadhli, (2015) Gestational diabetes is an issue that
occur only during pregnancy in women. In this situation, sugar level of pregnant lady gets
increased. The symptoms consisted of many factors such as tiredness, unreasonable thirst,
snoring, overweight, increase of urinary urgency and frequency. Women having gestational
diabetes must avoid intake of carbohydrates, alcohol, processed foods especially starch. One of
the major causes of this illness is that during pregnancy, hormones are developed by placenta.
This builds up blood sugar level among them. In normal cases, pancreas works to control the
glucose level by making enough insulin. At the time of pregnancy, level of insulin gets reduced,
that is why, pancreas fail to perform its work properly. When placenta connects baby to mother's
body at that time, many hormones get developed.
Tobias and et.al., (2018) argued that one of the major reasons of Gestational diabetes is
overweight. If a woman is unhealthy with weight issues, then it may increase chances of
diabetes. Women who are obese have insulin resistance issue and during pregnancy may
increase risk of suffering from Gestational diabetes.
According to Sebastiani and et.al., (2017) women older than 25 are at high risk of
suffering from Gestational diabetes. In this age, body of the lady fails to generate insulin at
required level that creates issues in pregnancy to a great extent.
Another major cause of this medical problem is family or personal health history. Individual
may get GD, if he already has pre-diabetes. In addition, if any family member has any issue then
this may pass genetically to the next generation. In such cases, there are high chances of
developing Gestational diabetes in women.
Spaight and et.al., (2016) stated that unhealthy diet is major cause of GD. It is important
for woman to take proper diet. If an individual is unable to have healthy dieting, then it might
create complications in pregnancy. Increased sugar level impacts child and mother, both badly.
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As baby gets nutrients from mother and if women’s sugar level is too high then baby stores
extra fat which impacts their growth to a great extent. In such condition, when delivery takes
place then there is high chances of injuries because of size of baby. Koivusalo and et. al., (2015)
argued that Gestational Diabetes impacts child after birth as well, when mother gives birth then
such kid may suffer from low blood sugar and minimum level.
As per the view of Pantham, Aye and Powell, (2015) if a woman suffers from GD, then
there are high chances of occurring breathing problems in both baby and mother. Gestational
diabetes causes premature births. Doctors suggest pre term delivery because size of baby gets
increased and fails to survive in woman’s body for longer duration. Many times, this increases
chances of occurring heart diseases in both babies and mothers. Due to GD, heart muscles of
baby becomes thick that may lead to rapid breathing issues.
Rationale
The topic has been provided by university, thus scholar has selected this topic for the
investigation. Investigator has huge interest in subjects related to medical thus, selected this topic
so that causes and impact of GD/diabetes in pregnancy can be identified. Number of cases
related to diabetes in pregnancy is increasing with rapid speed, and there are number of women
who have lost their premature babies during pregnancy (Who's at risk of gestational diabetes,
2015). By conducting this study, scholar will be able to find causes behind this disease and also
find some solutions to prevent women from this disease. From the past studies, it has been found
an increase of Gestational diabetes in every second woman. With the help of various resources,
the researcher will identify causes behind this increase of Gestational diabetes in women
especially during the first trimester of their pregnancy.
Significance
GDM is one of the most prevailing medical complications in pregnancy in the entire
world and can impact 1% to 35% of pregnant women, depending on the population. To execute
GD diagnosis, some criteria are used which have been undergoing some changes since 1960's.
This research is important because it will provide causes on increasing Gestational diabetes
among women (What is gestational diabetes, 2016). Over the years, it has been found that this
problem has been increasing day to day rapidly and doctors fail to know the reason behind it.
This report will be beneficial for upcoming researchers as a secondary data to continue their
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research. For them, it will give a basis to determine GD patients in identifying increase and
decrease of patient suffering from Gestational diabetes.
Research plan
Activities Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9
Topic
selection
Set aim and
objectives
Literature
review
Research
method
selection
Data
collection
Data
analysis
Draw
conclusion
Modificatio
ns as per
comment
provided
by client
Final
submission
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REFERENCES
Books and Journals
Alfadhli, E.M., 2015. Gestational diabetes mellitus. Saudi medical journal. 36(4). p.399.
DeSisto, C.L., Kim, S.Y. and Sharma, A.J., 2014. Peer reviewed: Prevalence estimates of
gestational diabetes mellitus in the United States, pregnancy risk assessment monitoring
system (prams), 2007–2010. Preventing chronic disease. 11.
Kamana, K.C., Shakya, S. and Zhang, H., 2015. Gestational diabetes mellitus and macrosomia: a
literature review. Annals of Nutrition and Metabolism. 66(Suppl. 2). pp.14-20.
Koivusalo, S.B and et. al., 2015. Gestational diabetes mellitus can be prevented by lifestyle
intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL): a
randomized controlled trial. Diabetes Care, p. dc150511.
Krejčí, H., 2016. Gestational Diabetes Mellitus. Vnitrni lekarstvi. 62. (11 Suppl 4). pp. S52-61.
Leng, J. and et.al., 2015. Prevalence of gestational diabetes mellitus and its risk factors in
Chinese pregnant women: a prospective population-based study in Tianjin, China. PloS
one. 10(3). p. e 0121029.
Pantham, P., Aye, I.L.H. and Powell, T.L., 2015. Inflammation in maternal obesity and
gestational diabetes mellitus. Placenta. 36(7). pp.709-715.
Sebastiani, G. and et.al., 2017. Circulating microRNA (miRNA) expression profiling in plasma
of patients with gestational diabetes mellitus reveals upregulation of miRNA miR-330-
3p. Frontiers in endocrinology, 8, p.345.
Spaight, C. and et.al., 2016. Gestational diabetes mellitus. In Novelties in Diabetes (Vol. 31, pp.
163-178). Karger Publishers.
Tobias, D.K. And et.al., 2018. Dietary intakes and circulating concentrations of branched-chain
amino acids in relation to incident type 2 diabetes risk among high-risk women with a
history of gestational diabetes mellitus. Clinical chemistry, pp. clinchem-2017.
Victor, D.J. And et.al., 2018. Tumor necrosis factor-alpha− 308 gene polymorphism in the
association between gestational diabetes mellitus and chronic periodontitis in South
Indian population. Journal of Pharmacology and Pharmacotherapeutics. 9(2). pp.109.
Waters, T.P. and et.al., 2018. 1012: Are changes in post-delivery glucose metabolism related to
changes in cytokines, adipokines or lipids in women with gestational diabetes mellitus.
American Journal of Obstetrics and Gynecology, 218(1), pp. S597-S598.
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Online
What is gestational diabetes. 2016. [Online]. Available through
:<https://www.healthline.com/health/gestational-diabetes>.
Who's at risk of gestational diabetes. 2015. [Online]. Available through
:<https://www.nhs.uk/conditions/gestational-diabetes>.
Gestational diabetes. 2014. [Online]. Available through: <https://www.google.co.in/search?
q=gestational+diabetes&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjLhL7axendAh
UIL48KHdUXA8gQ_AUIDigB#imgrc=1RHeEY7qQ-nHAM:>
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