Gestational Diabetes
Etiology: Risk factors for gestational diabetes include decreased physical activity, history of cardiovascular disease, abnormal fasting glucose test or glucose tolerance, insulin resistance, HbA1C higher or equal to 5.7%, hypertension, history of gestational diabetes, family history of diabetes mellitus, triglycerides more than 250 mg/DL, a body mass index above 25, polycystic ovarian syndrome, and HDL lower than 35 mg/Dl ( Quintanilla & Mahdy, 2022).
Epidemiology: Research shows that 2% to 10% of pregnant mothers in the United States experience gestational diabetes (Quintanilla & Mahdy, 2022).
Pathophysiology: Lactogen hormone released during pregnancy causes alteration of insulin receptors in the pregnant mother. Lactogen causes gestational diabetes by modifying phosphatidylinositol 3-kinase, insulin receptor substrate-1, and beta-subunit insulin receptor and diminishing tyrosine kinase phosphorylation. High glucose levels in the mother close the placenta to cause hyperglycemia in the fetus.
Clinical Manifestation: Obesity, disproportionate weight gain, elevated basal metabolic index, and abnormal plasma glucose values.
Diagnostic Tests:
2-hour plasma glucose above 200 mg/dL during a 75 g oral glucose tolerance test.
HbA1C of 6.5% or more than 6.5%.
Random plasma glucose of 200mg/dL in a symptomatic patient.
Fasting plasma glucose of 126 mg/dL or above 126 mg/dL.
Non-Pharmacological Treatment: Patients are advised on the advantages of glucose monitoring. Nutritionists recommend an individualized meal plan and dietary modifications for the patients. The patient is recommended a minimum of one fifty-minute exercise plan per week.
Pharmacological Treatment: Pharmacological treatment includes insulin and oral hypoglycemic agents such as metformin (Ganesan et al., 2022).
Drug of Choice: Insulin is the first-line treatment for gestational diabetes.
Education: Patients are educated on dietary changes, lifestyle modifications, and their treatment regimen, including insulin or hypoglycemic agents.
Follow-up: The patient is screened for type 2 diabetes six weeks after diabetes and every three years after delivery.
References
Ganesan K, Rana MBM, Sultan S. Oral Hypoglycemic Medications. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482386/
Quintanilla Rodriguez BS, Mahdy H. Gestational Diabetes. [Updated 2022 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545196/
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Question 
GESTATIONAL DIABETES
Discuss Etiology, Epidemiology, Pathophysiology, Clinical Manifestations, Work-up, Nonpharmacological and Pharmacological Management, Education, and Follow-up for a gynecology or pregnancy diagnosis or consideration. 500 words or less for the initial post.
Gestational Diabetes
For peer posts and subsequent posts under the initial discussion board thread, add in second and third-line treatments and additional considerations (250 words maximum for responses). For example requirement, only evidence-based sources, such as AAFP, CDC, IDSA, ADA, JNC 8, etc. (textbook resources and internet sites affiliated with medical associations are considered credible sources to obtain the information on the most up-to-date guidelines). Add the link to the guidelines within the discussion board for further reading by your peers.
Length: A minimum of 250 words, not including references
At least one high-level scholarly reference in APA from within the last 5 years
Pls, follow the same format for pediatric illness guidelines with links in the body.
StatPearls. https://pubmed.ncbi.nlm.nih.gov/29489290/
https://www.cdc.gov/diabetes/basics/getting-tested.html
file:///C:/Users/13233/OneDrive/Desktop/APEA%20Support%20Category%20-%20Clinical%20Guidelines%204th%20Edition.html