Gestational Diabetes and African-American Women
Comment by Sabina:

Gestational Diabetes is a diagnosis of diabetes during pregnancy. This diagnosis is usually obtained about the 24th week of pregnancy after taking a blood glucose test. A diagnosis of gestational diabetes does not mean the individual is going to become diabetic after pregnancy or was diabetic prior to pregnancy. Gestational diabetes is usually caused by the imbalance of hormones during pregnancy, along with other biological factors such as a decrease in pancreatic production of insulin. I will discuss how the diagnosis is obtained, how it is treated, medication that can be used, ethical and cultural affiliation with gestational diabetes. Finally I will also discuss some controversies surrounding this disease and how it impacts African-American females.

What is Gestational Diabetes?

According to American Diabetic Association (ADA, 2011) gestational diabetes affects about 4% of all pregnant women in the United States, about 135,000 women per year. Scientist currently…...

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References

ADA (2011). What is Gestational Diabetes? American Diabetes Association. Retrieved from  http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html 

Anderwald et. al. (2011). Glucose absorption in gestational diabetes mellitus during an oral glucose tolerance test. Diabetes Care. 34 (7) 1475-1480

Bowers et. al. (2011). A prospective study of prepregnancy dietary iron and risk for gestational diabetes mellitus. Diabetic Care. 34 (7) 1557-1563

Costan, D.R. (2007). Pharmacological Management of Gestational Diabetes. Diabetic Care. 30 (2) 206-208

Gestational iabetes Mellitus: Implications for Pre-Screening and Type II
iabetes

Gestational iabetes Mellitus

Implications for Pre-Screening in Type II

Screening of patients for the condition of "gestational diabetes mellitus" is considered to be an extravagance from the perspective of Lepercq (2004) who considered Universal Screening to be "contentious." However due to the 6.4% mortality rate due to untreated diabetes mellitus as well as the know birth defects and maternal health effects there are those who consider pre-screening for GM to be vital in terms of the health of the expected mother and expected child. There exist implications for the lack of prescreening in terms of ethical responsibility as well as in terms of costs realized in universal screening. Systemic study of this subject is necessary in understanding what the best practice in pre-screening actually is.

Gestational iabetes Mellitus

Implications for Pre-Screening in Type II

- Type 1 and Type 2

Statement of Thesis:

Screening of patients for gestational diabetes…...

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Diagnosis of diabetes mellitus identifies those at risk of developing type 2 diabetes. "The uncertainty surrounding the level of glucose intolerance that should be treated as gestational diabetes is highlighted." McElduff (2003) A study conducted in relation to newly diagnosed diabetes mellitus and the symptoms or conditions to watch for states that: "Screening for diabetes makes good sense in particular in patients with overweight, hypertension ....For Type 2 diabetes is often not recognized until sequelae have put in appearance." Palitzsch (2004)

It is apparent that further study is needed in this area of pre- and peri-natal health care in order to provide the most ethical and superior care for expectant parents and expected children.

In a study entitled "Epidemiology of gestation diabetes mellitus and its Association with Type 2 Diabetes" states that in reality GDM or "Gestational

Gestational Diabetes Case Study
Subjective

State the patient's chief complaint, reason for visit and/or the problem for which you are providing follow-up.

The client is a 30-year-old 27 weeks pregnant Hispanic-American woman in her third pregnancy. The client is married and has two children living at home and no history of miscarriage.

All symptoms related to the problem are described using the following cue descriptive categories:

Precipitating/alleviating factors (including prescribed and/or self-remedies and their effect on the problem).

The client denies any attempted self-remedies for her gestational diabetes mellitus (GDM), which is defined as experiencing intolerance to glucose that is initially identified during pregnancy (Jafari-Shobeiri & Ghojazadeh, 2015).

2) Associated symptoms

The client reports frequent urination and being thirsty much of the time which are both consistent with a diagnosis of GDM (Mcgill, 2015).

3) Quality of all reported symptoms including the effect on the patient's lifestyle

The client reports no significant adverse effects as a result of GDM.

4) Temporal…...

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References

Jafari-Shobeiri, M. & Ghojazadeh, M. (2015, August). Prevalence and risk factors of gestational diabetes in Iran: A systematic review and meta-analysis. Iranian Journal of Public Health, 44(8), 1036-1041.

Liberatore, S. (2009, September). Q: What causes diabetes, and how does it affect a person's health? The Science Teacher, 76(6), 68.

Malmqvist, E. & Jakobsson, K. (2013, April). Gestational diabetes and preeclampsia in association with air pollution at levels below current air quality guidelines. Environmental Health Perspectives, 121(4), 488-491.

McGill, N. (2015, March). Gestational diabetes: A risk during pregnancy. The Nation's Health, 45(2), 20.

Meta-AnalysesThe selected study (Dalenerolle et al., 2021) sought to determine whether race influenced the risk of gestational diabetes and related mental health disorders among ethnic minorities. The findings showed a sequelae of gestational diabetes with mental health disorders among minority ethnic groups, supporting the hypothesis that Asians, blacks, and other ethnic minorities are disproportionately affected (Dalenerolle et al., 2021).Dekkers (2018) defines a meta-analysis as a formal, quantitative study design in which one combines related studies that answer the same research question into one design and uses statistical analyses to draw conclusions from the design. The selected study exhibits several features that make it a meta-analysis. First, the authors use standard eligibility criteria to integrate 14 eligible studies into one data set that they analyze using statistical processes to reach their finding. Eligible studies are non-randomized or randomized controlled trials (RCT) published between November 1995 and November 2020 and analysing both…...

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References

Campinha-Bacote, J. (2002). Cultural competence in psychiatric nursing: Have you asked the right questions? Journal of the American Psychiatric Nurses Association, 8(6), 183-87.

Dalenerolle, G., Phiri, P., Zeng, Y.,…& Hapangama, D. (2021). A systematic review and meta-analyses of gestational diabetes mellitus and mental health among BAME populations. EClinical Medicine, 38, (1), 1-23.

Dekkers, O. M. (2018). Meta-analysis: Key features, potentials, and misunderstandings. Research and Practice in Thrombosis and Haemostasis, 2(4), 658-63.

Gestational Diabetes Amongst North American Pregnant Mothers: esponses
Crowther, Hiller, Moss et al. (2005) show that "treatment of gestational diabetes reduces serious perinatal morbidity" -- more so than simple routine care, so that was an interesting discovery based on the questions posed by Nelson and isa. The fact that gestational diabetes does affect both the mother and the embryo/fetus is indeed troubling -- and it got me thinking about how the interventions impacted both. After reviewing the study by Crowther, Hiller Moss et al. (2005), however, I was interested in seeing what other studies showed about the relationship between gestational diabetes, fetal growth, and treatment.

The study by Catalano, Kirwan, Mouzon and King (2003) confirmed the assertion of Nelson and isa that there is increased risk for the offspring, especially if there is evidence of pregestational diabetes. What was one consolation however was the finding within the same study that "women with…...

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References

Catalano, P, Kirwan, J., Mouzon, S., King, J. (2003). Gestational diabetes and insulin resistance: Role in short- and long- term implications for mother and fetus. The Journal of Nutrition, 133(5): 16745-16835.

Crowther, C., Hiller, J., Moss, J. et al. (2005). Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. The New England Journal of Medicine, 352: 2477-2486.

Reece, A. (2010). The fetal and maternal consequences of gestational diabetes mellitus.

The Journal of Maternal-Fetal & Neonatal Medicine, 23(3): 199-203.

Another author notes, "African-American women are at an increased risk for developing gestational diabetes, experts say. Much like other forms of diabetes, gestational diabetes affects the way your body uses blood sugar (glucose). In the case of gestational diabetes, your blood-sugar level is too high" ("Exercise & pregnancy," 2006). Women suffering from gestational diabetes are also more prone to suffer from toxemia, as well. Another writer states, "Compared with women who don't have diabetes, women with diabetes are up to five times more likely to develop toxemia, a disorder marked by hypertension, protein in the urine, swelling, headache, and visual disturbances" (Meadows, 2001, p. 7). Exercise has proven to help remove the risk of gestational diabetes in some women, especially those who are overweight when they become pregnant.
Fortunately, for the women who find themselves suffering from gestational diabetes, there are ways to control or manage the disease. Gestational diabetes…...

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References

Exercise & pregnancy: Staying fit through the nine months. (2006, May). Ebony, 61, 100+.

Gestational diabetes. (2007). Retrieved 19 Nov. 2007 from the American Diabetes Association Web site:  http://www.diabetes.org/gestational-diabetes.jsp .

Lewis, C. (2002, January/February). Diabetes: A growing public health concern. FDA Consumer, 36, 26+.

Meadows, M. (2001, November/December). Encouraging women to take charge of diabetes: About 8.1 million women in the United States have diabetes, and one-third of them don't know it. FDA Consumer, 35, 7.

Screening for Gestational Diabetes
Gestational diabetes mellitus (GDM) is caused by the development of glucose intolerance during pregnancy (National Institutes of Health 2013). In the United States the National Institutes of Health (2013), U.S. Preventive Services Task Force (2008), and the American Diabetes Association (2013) are just a few agencies and organizations who have weighed in on this topic. Elsewhere, the Cochrane Systematic eviews (Tieu et al. 2010) and the World Health Organization (WHO 2013a) have also published their recommendations. Despite the overwhelming number of recommendations concerning GDM, the best GDM screening protocols, diagnostic methods, and treatment approaches remain controversial.

To better understand recommended best practices for GDM care this proposal will first examine what is known about this disease and then review the evidence-based rationales underlying current recommendations. Particular attention will be paid to the health care challenges facing emerging developed nations, in particular Saudi Arabia.

GDM Epidemiology

The International Diabetes Federation (IDF…...

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References

ACOG (2013) 'Practice Bulletin No. 137: Gestational Diabetes Mellitus'. Obstetrics and Gynecology 122(2), 406-16

Al-Daghri, N.M., Al-Attas, O.S., Alokail, M.S., Alkharfy, K.M., Yousef, M., Sabico, S.L., and Chrousos, G.P. (2011) 'Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): A decade of an epidemic'. BMC Medicine 9(1), 1-6

Alto, W.A. (2005) 'No need for glycosuria/proteinuria screen in pregnant women'. Journal of Family Practice 54(11), 978-83

American Diabetes Association (2013) 'Standards of Medical Care in Diabetes -- 2013'. Diabetes Care 36(suppl. 1), S11-66

SYNTHESIS Gestational diabetes mellitus (GDM), glucose intolerance recognized during pregnancy, affects approximately 7% of all pregnancies in the United States. GDM, diagnosed by an abnormal oral glucose tolerance test (OGTT) done during the second trimester. Women diagnosed with GDM are at a high risk of developing type 2 diabetes, cardiovascular disease, and hypertension. With this prevalence, the American Diabetes Association (ADA) has recommended screening women with GDM 6-12 weeks after delivery, which roughly coincides with the timing of their first postpartum visit. For almost 90% of women diagnosed with GDM, glucose intolerance will resolve immediately after delivery, but their risk of developing type 2 diabetes mellitus is 35% to 60%. There is also a likelihood of the woman adversely affecting their future offspring when they become pregnant again with undiagnosed type 2 diabetes mellitus or they experience recurrent GDM. There is a need to analyze the factors contributing to and hinder…...

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References

Bandyopadhyay, M., Small, R., & Davey, M.-A. (2015). Attendance for postpartum glucose tolerance testing following gestational diabetes among South Asian women in Australia: A qualitative study. J Womens Health Issues Care, 4(1), 1-8.

Carson, M. P., Morgan, B., Gussman, D., Brown, M., Rothenberg, K., & Wisner, T. A. (2015). SUGAR: spotting undiagnosed glucose abnormal results—a new protocol to increase postpartum testing among women with gestational diabetes mellitus. American journal of perinatology, 32(03), 299-306.

Carter, E. B., Martin, S., Temming, L., Colditz, G., Macones, G. A., & Tuuli, M. G. (2018). Early versus 6–12 week postpartum glucose tolerance testing for women with gestational diabetes. Journal of Perinatology, 38(2), 118-121.

Cho, G. J., An, J.-J., Choi, S.-J., Oh, S.-y., Kwon, H.-S., Hong, S.-C., & Kwon, J.-Y. (2015). Postpartum glucose testing rates following gestational diabetes mellitus and factors affecting testing non-compliance from four tertiary centers in Korea. Journal of Korean medical science, 30(12), 1841-1846.

Korpi-Hyövälti, E., Laaksonen, D. E., Schwab, U., Heinonen, S., & Niskanen, L. (2012). How can we increase postpartum glucose screening in women at high risk for gestational diabetes mellitus? International journal of endocrinology, 2012.

Man, B. (2016). Diabetes Screening in US Women with a History of Gestational Diabetes. Division of Epidemiology and Biostatistics Michelle A. Kominiarek ….

Rosenbloom, J. I., & Blanchard, M. H. (2018). Compliance with postpartum diabetes screening recommendations for patients with gestational diabetes. Journal of women\\'s health, 27(4), 498-502.

Shah, B., Lipscombe, L., Feig, D., & Lowe, J. (2011). Missed opportunities for type 2 diabetes testing following gestational diabetes: a population?based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 118(12), 1484-1490.

Essay Topic Examples
1. Understanding Gestational Diabetes: Causes and Risk Factors:
     This topic explores the underlying causes of gestational diabetes, focusing on how hormonal changes during pregnancy can affect insulin resistance. It discusses the risk factors, such as obesity, family history, and previous gestation with gestational diabetes, that contribute to the development of the condition in pregnant women.

2. The Impact of Gestational Diabetes on regnancy and Birth Outcomes:
     In this essay, the focus is on examining the consequences of gestational diabetes for both the mother and the child, including potential complications like preeclampsia, high birth weight, and the increased likelihood of cesarean delivery. The discussion also covers the long-term risks for both mother and child, such as developing type 2 diabetes later in life.

3. Screening and Diagnosis of Gestational Diabetes:
     This essay delves into the diagnostic criteria for gestational diabetes, revealing the…...

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Primary Sources

American Diabetes Association. \"2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2021.\" Diabetes Care 44.Supplement 1 (2021): S15-S33.

Chiefari, Eusebio, et al. \"Gestational Diabetes Mellitus: An Updated Overview.\" Journal of Endocrinological Investigation 40.9 (2017): 899-909.

International Association of Diabetes and Pregnancy Study Groups Consensus Panel. \"International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy.\" Diabetes Care 33.3 (2010): 676-682.

Committee on Practice Bulletins—Obstetrics. \"Practice Bulletin No. 190: Gestational Diabetes Mellitus.\" Obstetrics & Gynecology 131.2 (2018): e49-e64.

Metzger, Boyd E., et al. \"Hyperglycemia and Adverse Pregnancy Outcomes.\" The New England Journal of Medicine 358.19 (2008): 1991-2002.

Diabetes in Australia
The Australian government and the relevant Health agencies have for many years strived to put the diabetes menace under close observation and management. There have been massive researches and huge sums directed towards good management and possible elimination of diabetes at the national levels. This commitment is exhibited by the specialized funds and efforts like the Juvenile Diabetes esearch Fund (JDF) that has been committed to striving to mitigate the effects of diabetes from the render age of the Australians.

Since diabetes is such a big challenge to Australia as a whole, diabetes mellitus was declared a National Health Priority Area in 1996 during the Australian Health Minister's Conference and this was as recognition to the high levels of diabetes prevalence within Australia, the mortality rates that were due to it, the impact it had on morbidity and the possibility of the health improvements that can be achieved from…...

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References

American Diabetes Association, (2013). Kidney Disease (Nephropathy). Retrieved May 13, 2013 from  http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html 

Australian Government, Department of Health and Ageing, (2012). Diabetes. Retrieved May 13, 2013 from  http://www.health.gov.au/internet/main/publishing.nsf/Content/pq-diabetes 

Australian Institute of Health and Welfare, (2011). Diabetes Prevalence in Australia Detailed estimates for 2007 -- 08. Retrieved May 13, 2013 from  http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737419307 

Baker IDI, Heart & Diabetes Institute (2013). Diabetes: The Silent Pandemic and its Impact on Australia. Retrieved May 13, 2013 from  http://www.diabetesaustralia.com.au/Documents/DA/What%27s%20New/12.03.14%20Diabetes%20management%20booklet%20FINAL.pdf

However, advancements in pharmacogenetics promises new and better ways of managing diabetes. Studies have shown that Lisofylline, an anti-inflammatory compound is very effective in suppressing the autoimmune activity and in improving the islet secretion of insulin. Mice studies showed significant difference (25% vs. 91.6%) in the onset of diabetes among Lisofylline treated mice compared to placebo mice. Reduction of inflammatory cytokines IFN-? And TNF-? levels correlated with reduction in ss cell apoptosis. [Yang et.al, 2003] Recent study by Lipsett et.al (2007) has shown that Islet Neogenesis-Associated Protein (INGAP) is useful as a pancreatic regeneration agent. Successful tests in mice and regeneration of cultured human pancreatic cells have encouraged the researchers to seriously consider INGAP as an effective agent for improving insulin synthesis. [Lipsett et.al, (2007)]
A recent Cornell University study focused on an entirely different approach to diabetes management. The researchers examined the possibility of recombinant Commensal bacteria engineered to…...

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Bibliography

1) George S. Eisenbarth, (2007) 'Update in Type 1 Diabetes', The Journal of Clinical Endocrinology & Metabolism Vol. 92, No.7.  http://jcem.endojournals.org/cgi/content/full/92/7/2403 

2) McGill University, 'Deficient Regulators in the Immune System Responsible for Type 1 Diabetes', Updated 25 Jan 2008, Available at,  http://www.sciencecentric.com/news/article.php?q=08012539 

3) Kent SC, Chen Y, & Bregoli L. et.al (2005) 'Expanded T cells from pancreatic lymph nodes of type 1 diabetic subjects recognize an insulin epitope'. Nature 435:224 -- 228

4) Mathieu C, Gysemans C. et.al (Jul 2005), 'Vitamin D and Diabetes', Diabetologia. 48(7):1247-57

Diabetes Education
What is Diabetes?

Interventions

Management

Self-Care

Diabetes Education

Clinical Practice ecommendations

Diabetes Education

Diabetes is considered to be a chronic disease which really needs some kind of long-term nursing and medical intermediations. esearch shows that patients likewise need to take a part that is active in their own treatment and management, and the alter their lifestyles in order to keep their metabolic state at a level that is normal (Sperl-Hillen, 2010). One of the transformations in education is recognized as being electronic learning. This technique is interesting because it has all of these unique features which users are interested in using, and has made it possible to learn anywhere. It facilitates individual as well as group learning, and makes it conceivable to familiarize the material as stated by the users' needs. However, in the last 10 years, it has been very obvious that the Internet has turned out to be a very rich source of healthcare…...

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Reference:

EIJJ, V. (2009). Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. The Cochrane Library, 44(8), 1-44.

Marjatta Kelo, M.M. (2011). Self-care of school-age children with diabetes: an integrative review. JOURNAL OF ADVANCED NURSING, 2096-2105.

Marzieh Moattari, M.H. (2012). The impact of electronic education on metabolic control indicators in patients with diabetes who need insulin: a randomised clinical control. Journal of Clinical Nursing, 22, 32 -- 38.

Sperl-Hillen, J. (2010). Are benefits from Diabetes Self-Management education Sustained? American Journal of Managed Care is the property of Intellisphere, 104-113.

Untreated diabetes can result in serious deterioration of the circulatory system as a consequence of long-term exposure to elevated blood glucose levels (NIDDKD, 2006). By monitoring blood glucose levels and administering insulin to reduce glucose concentration in the blood, many patients can carry on with their lives without significant effects of the disease (ADA, 2009).
However, undiagnosed or untreated diabetes can have very serious effects on the body and consequences for the patient. Among those effects and consequences are kidney damage, cardiac and circulatory system damage, as well as vision problems leading to increasing blindness (ADA, 2007; ADA, 2009). Because untreated or insufficiently managed diabetes often results in decreased circulation to the extremities, diabetes is also associated with the significant risk of losing fingers, toes, and even arms or legs. Once circulation is reduced below the minimum level required to oxygenate tissues enough to sustain them, the patient is at…...

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References

American Diabetes Association. (2007). "Diabetes and women's sexual health"

Retrieved July 31, 2009, from:  http://www.diabetes.org/type-1-diabetes/women-sexual-health.jsp .

American Diabetes Association. (2009). "Standards of medical care in diabetes"

Retrieved July 31, 2009, from:

NR 601 Week 5 Case StudyNR 601 Week 5 Case StudyThe World Health Organization (WHO) defines diabetes as a disease that affects the bodys ability to prepare or produce the hormone insulin, resulting in abnormal metabolism of blood glucose and elevated levels of the same in the blood (WHO, 2021). When an individual has diabetes, their body either does not make sufficient insulin or fails to make use of insulin as it should, causing elevated levels of blood sugar in the bloodstream. There are three types of diabetes: Type 1 diabetes, Type 2 diabetes, and Gestational Diabetes (CDC, 2020). The Center for Diseases Prevention and Control (CDC) estimates that 34 million (representing 1 in every 10) Americans have diabetes, and 90-95 percent of these patients have Type 2 diabetes (CDC, 2020). The high prevalence of diabetes calls for adequate understanding on the part of healthcare providers to ensure effective diagnosis…...

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ReferencesADA Standards of Medical Care (2021). Standards of Medical Care in Diabetes – 2021 Abridged for Primary Care Providers. American Diabetes Association. Retrieved from M., Salas, R., Garza, Y., Villareal, J., Sureda, A., & Tur, J.(2016). Serum Lipid Profile, Prevalence of Dyslipidemia and Associated Risk Factors among Northern Mexican Adolescents. Journal of Pediatric Gastroenterology and Nutrition, 63(5), 544-49.Bigelow, A., & Freeland, B. (2017). Type II Diabetes Care in the Elderly. The Journal for Nurse Practitioners, 13(3), 181-86.CDC (2021). Diabetes Symptoms. Center for Diseases Prevention and Control (CDC). Retrieved from https://www.cdc.gov/diabetes/basics/symptoms.htmlCDC (2020). What is Diabetes? Center for Diseases Prevention and Control (CDC). Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.htmlFDA (2017). Glucophage. Food and Drug Administration (FDA). Retrieved from  https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020357s037s039,021202s021s023lbl.pdfGalicia-Garcia , U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K., Ostolaza, H., & Martin, C. (2020). Pathophysiology of Type II Diabetes Mellitus. International Journal of Molecular Sciences, 21(17), 6275-81.Hill, M., & Bordoni, B. (2021). Hyperlipidemia. Treasure Island, FL: Statpearls PublishingHuang, W., Xu, W., Zhu, P., Yang, H., Su, L., & Tang, H.(2017). Analysis of Blood Glucose Distribution Characteristics in a Health Examination Population in Chengdu (2007-2015). Medicine, 96(49), Doi: 1097/MD.0000000000008765Molugulu, N., Yee, L., Ye, Y., Khee, T., Nie, L., Yee, N., Yee, T., Liang, T., & Kesharwani, P. (2017). Systematic Review of Metformin Monotherapy and Dual Therapy with Sodium Glucose Co-Transporter 2 Inhibitor (SGLT-2) in Treatment of Type II Diabetes Mellitus. Diabetes Research and Clinical Practice, 132(1), 157-68.NIH (2021). Diabetes Tests and Diagnoses. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from  https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis#whichtestsPiva , S., Susko, A., Khoja, S., Josbeno, D., Fitzgerald, G., & Toledo, F. (2015). Links between Osteoarthritis and Diabetes: Implications for a Physical Activity Perspective. Clinical Journal of Geriatric Medicine, 31(1), 67-87.Storey, H. L., Pelt, M., Bun, S., Daily, F., Neogi, T., Thompson, M., McGuire, H., & Weigl, B. (2017). Diabetes and Endocrinology, 8(3), 1-8.WHO (2021). Diabetes. World Health Organization (WHO). Retrieved from  https://www.who.int/health-topics/diabetes#tab=tab_1https://clinical.diabetesjournals.org/content/diaclin/early/2020/12/02/cd21-as01.full.pdfBibiloni,

Diabetes and Drug Treatments
TYPE II DIABETES AND DUG TEATMENTS

Differences

Type I Diabetes

Diabetes mellitus type 1 result from autoimmune destruction of insulin-producing beta cells within the pancreas. Subsequent shortage of insulin translates to increased urine and blood glucose. The developed world is associated with increasingly variant type I diabetes with a large cause of kidney failure and non-traumatic blindness. The link is based on an increased dementia and cognitive dysfunction risk through disease processes of vascular dementia and Alzheimer's disease. The complications are inclusive of sexual dysfunction, acanthosis nigricans, and frequent infections (Jones, et al., 2012).

Type II Diabetes

The classic diabetes symptoms include polyuria (frequent urination), increased thirst, increased hunger (polyphagia), and weight loss. Alternative symptoms commonly presented in the diagnosis include histories of blurred vision, fatigue, recurrent vaginal infections, peripheral neuropathy, and itchiness (Barnett, 2012). However, many people lack symptoms in the initial years and while the diagnosis is presented to routine…...

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References

Barnett, A. (2012). Type II Diabetes. New York: OUP Oxford.

Ezrin, C. & Kowalski, R. (2011). The Type 2 Diabetes Diet Book, Fourth Edition. McGraw Hill Professional

Jones, R. M. et al., (2012). New Therapeutic Strategies for Type 2 Diabetes: Small Molecule Approaches. New York: Royal Society of Chemistry

Pereira, M. A. (2013). Nutrition and Type II Diabetes: Etiology and Prevention. New York: CRC Press.

I. Introduction
A. Background information on teenage pregnancy
B. Thesis statement

II. Causes of Teenage Pregnancy
A. Lack of sex education
1. Insufficient knowledge about contraception methods
2. Misinformation about pregnancy prevention
B. Peer pressure
1. Influence from friends and social groups
2. Desire for acceptance and popularity
C. Absence of parental guidance
1. Lack of communication within the family
2. Deterioration of family values and morals

III. Consequences of Teenage Pregnancy
A. Health risks for the mother and child
1. Increased likelihood of complications during pregnancy and childbirth
2. Higher rates of preterm birth and low birth weight babies
B. Education....

Outline of the Potential Risks and Challenges Associated with Teenage Pregnancy

I. Physical Risks to the Mother
A. Preterm labor and premature birth
B. Low birth weight babies
C. Gestational diabetes
D. Preeclampsia and eclampsia
E. Postpartum hemorrhage
F. Cesarean delivery

II. Physical Risks to the Baby
A. Prematurity and its associated health problems
B. Low birth weight and its associated health problems
C. Cerebral palsy
D. Mental retardation
E. Respiratory distress syndrome
F. Jaundice

III. Social and Emotional Risks to the Mother
A. Dropping out of school
B. Poverty
C. Homelessness
D. Child abuse and neglect
E. Mental health problems
F. Relationship....

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Evidence of Metabolic Changes with Maternal Anxiety in Pregnancy

Maternal anxiety during pregnancy has been associated with various metabolic changes that can impact both the mother and the developing fetus. Several studies have explored the relationship between maternal anxiety and metabolic alterations, shedding light on how these changes can influence maternal and fetal health. This literature review will summarize the evidence regarding metabolic changes in pregnant women with anxiety.

One study by Smith et al. (2017) showed that pregnant women with high levels of anxiety had higher levels of cortisol, a stress hormone that can affect metabolism. Cortisol....

Metabolic Changes Associated with Maternal Anxiety During Pregnancy

Introduction

Maternal anxiety during pregnancy is a common and concerning issue, with studies suggesting a prevalence of up to 40% of women experiencing moderate to severe anxiety symptoms (Menezes et al., 2022). Anxiety during pregnancy has been linked to a range of adverse outcomes for both mother and baby, including preterm birth, low birth weight, and increased risk of developmental problems (O'Connor et al., 2019).

Emerging evidence suggests that maternal anxiety during pregnancy is associated with significant metabolic changes, which may contribute to these adverse outcomes. This literature review will explore the current evidence linking....