Aug 3, 2020 in Medicine Essay

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Common Pregnancy Complication: Gestational Diabetes Mellitus among Hispanic/Latino Cultural Group

Gestational diabetes mellitus (GDM) is a type of diabetes that happens when a woman is pregnant. It is a condition evidenced by carbohydrate intolerance, which contributes to hyperglycemia during pregnancy. The cause of GDM is thought to be the placental hormones that tend to induce insulin resistance. The insulin hormone facilitates the metabolism of glucose; however, when there is insulin resistance, the level of glucose in the blood is relatively high due to reduced glucose metabolism. GDM contributes to both infant and maternal complications. The Hispanic population of the United States of America is the ethnic minority group, but it is growing fast, and it forms a significant portion of the U.S. racial composition. GDM tends to affect Hispanic women more than non-Hispanic women. The socioeconomic factors, cultural factors, and political variables are thought to play a role. However, these factors interact in a complex and interwoven manner such that it is hard to delineate and classify the variables. The language barrier, education background, socioeconomic factors, and political variables like the Latino subgroups tend to influence the risk and accessibility of health services.

This paper aims to explore the Hispanic women predisposition to GDM via assessment of this condition, taking into account cultural, political, and socioeconomic variables. Finally, the paper will describe gestational diabetes mellitus prevention strategies, introduce a plan to implement the prevention strategies together with possible obstacles, and evaluate such a plan.

Assessment of GDM among the Hispanic Population

Gestational diabetes mellitus has been one of the critical gynecological problems facing the Hispanic population in the United States of America. Findings indicate that the Hispanic or Latino population is more predisposed to GDM than the rest of the population (Hawkins et al., 2015). Recognizable specific factors have not been pinpointed in almost half of the affected women, and research findings on the same issue are still sparse (Chasan-Taber et al., 2010). Genetics is a major factor that contributes to higher GDM risks among the Hispanics, and most of the women are not even aware that they have diabetes during pregnancy. The Hispanics are at a greater risk of getting diabetes at a young age when compared with other ethnic groups. This risk makes it necessary to give considerable focus to the diabetes management starting from the women who get pregnant at young adulthood.

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Within the Hispanic or Latino population, the risk for type 2 diabetes varies significantly amongst the Latino ethnic groups. The time an individual has stayed in the United States of America influences their predisposition to diabetes. Economic reasons such as job strain and associated lifestyle factors are blamed for the rising cases of diabetes amongst Latinas. Research findings show that women who performed exercise and more household activities experienced a reduced risk of GDM during mid-pregnancy (Chasan-Taber et al., 2010). American College of Obstetricians and Gynecologists (ACOG) recommends 30 minutes of moderate physical activity each day in pregnancies so long as there is no prescribed contradiction. Physical exercise or activity plays a significant role in the reduction of weight; obesity characterized by an increased body mass index has been one of the key contributors to the development of diabetes (Rhoads-Baeza & Reis, 2012). Physical activity and nutritional interventions do not bring a significant impact in obesity cases during pregnancy and do not contribute to the lowering of cases associated with infant complication, including macrosomia (Hieronymus, Combs, Coleman, Ashford, & Wiggins, 2016). Chasan-Taber and others (2010) point out that women diagnosed with GDM are at a greater risk of getting diabetes in future. The children of these mothers are more predisposed to diabetes.

Weight gain in reproductive age is prevalent, and this contributes to obesity and overweight during pregnancy. Obesity and overweight tend to bring pregnancy complications, which include gestational diabetes mellitus, pregnancy hypertension, preeclampsia, and caesarean delivery (Chasan-Taber et al., 2015). Chasan-Taber et al. (2015) observed that gestational weight gain (GWG) was excessive in Hispanic women. It has been dominantly noted that Hispanic women are more predisposed to gestational diabetes mellitus than non-Hispanic women (Joiner et al., 2016). Due to cultural variables, socioeconomic factors, education background differences, and language barriers, Hispanics are noted to have experienced limited access to activities that involve public health intervention and health promotion programs.

Management of GDM

Given that the Hispanic women are profoundly affected by the GDM in comparison with any other race, it is prudent to come up with strategies that are geared towards management of the condition in this ethnic group. Health intervention programs and health promoting activities ought to take into account both political and cultural variables. The Hispanic sociocultural practices ought to be harmonized with the GDM management approach.

Firstly, medical nutrition therapy should be suggested. The goal of this plan is to provide sufficient nutrients and calories during pregnancy while maintaining blood sugar levels within a given range of values. However, there has been no specific consensus on nutritional medical treatment approach for GDM (Yuen & Wong, 2015). Yuen and Wong (2015) suggest that a diet containing higher complex carbohydrates, higher fiber, low sugar, and low saturated fats can be a remedy for the reduction of postprandial hyperglycemia and can hinder insulin resistance. Specific dietary intake ought to be prescribed by an accredited dietician and should be tailored to meet the individual and cultural needs of the clients. Some ethnic groups and individuals may be accustomed to certain foods; the dietician ought to take this difference into consideration.

The second GDM management approach is coming up with specific community-based programs or plans. The elaborate plan involves coming up with a team of health care providers, dieticians, and the target clients who will engage in fruitful health interactions. Community-based programs should aim at improving health outcomes in diabetes. One of the key aspects of the community-based plan is education on the diabetes prevention methods, nutritional advice, and health promotion activities like encouraging physical exercise among young women at reproductive age.

Community-Based Diabetes Management Plan for GDM

One of the key GDM management plans is the community-based program. Success in diabetes management plans is vivid when the community-based program is used (Philis-Tsimikas & Gallo, 2014). It involves such key pillars as client self-management, delivery system model, and community resources. The self-management education aspect facilitates self-care habit, improves knowledge, health coping, lowers health costs, and guarantees an improved clinical outcome (Philis-Tsimikas & Gallo, 2014). It is important to engage educators and community health workers in enlightening the Hispanic women about GDM. Diabetes education has contributed to an increased utilization of preventive and primary care services. The peer-led diabetic team composed of women who are at risk for GDM or have had GDM can be a vital part of the community-based program. The participants in the peer-led diabetic management approach demonstrate reduction in blood pressures, favorable lipids level, improved physical activity or exercise, and improved culturally-driven diabetic perspectives (Philis-Tsimikas & Gallo, 2014).

Some problems are likely to face the community-based GDM program. These obstacles may include language barriers, poorly coordinated health care transitions, cultural variations, and inadequate diabetes health staff. When initiating a program, it is essential to put in place the mechanisms that would deter the occurrence of such problems. In the language barrier aspect, it is necessary to recruit professional interpreters. Healthcare transitions have to be strengthened through the embracement of efficient follow-up and proper documentation. GDM health services have to be culturally sensitive; the delivery of services ought to be tailored to meet specific client needs. To solve the case of insufficient staff, it is recommended to seek adequate finance or utilize alternative financing options so as to get the appropriate staff.

Evaluation of the Community-Based Program

Evaluating the performance of the program is vital. The evaluation would need to take into account various aspects, including improved knowledge levels about GDM, improved health behaviors such as intake of recommendable diets, and improved physical exercise. Other parameters requiring evaluation include changes in blood pressure, lipids level, and reduction of GDM complications and weight values among the clients predisposed to GDM (Tang et al., 2015).

Conclusion

GDM is associated with carbohydrate imbalance during pregnancy. It affects Hispanic women more than non-Hispanic women. Multiple interwoven socioeconomic, cultural, and political variables may also play a role. Inadequate physical exercise, overweight, obesity, psychological stress, and genetic predisposition have been cited as key issues in GDM. Since the prevalence of GDM is profound in Hispanic women, it is prudent to come up with the management plan that will best suit this population and that is culturally sensitive and individualized. Such therapeutic approach ought to produce improved clinical outcomes with lower risks of GDM complications.

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