Experience of Self-monitoring of Blood Glucose in Pregnancy

Experience of Self-monitoring of Blood Glucose in PregnancyLived Experience of Self-monitoring of Blood Glucose among expectant Women with Gestational Diabetes MellitusAbstract primeval wordsSelf-monitoring of furrow glucose, gestational diabetes mellitusINTRODUCTIONGestational diabetes mellitus (GDM) is defined as impaired glucose border graduation exercise identified during pregnancy. It is diagnosed using a 75g or 100 g oral glucose tolerance streamlet according to clinical practice guidelines. The prevalence of gestational diabetes mellitus among meaning(a) women is increasing worldwide beca hire of edematous eating and lack of exercise. Prepregnancy overweight and gestational weight gain be the strongest predictors of GDM (Savona-Venturaet al.,2013). Previous studies showed that 5.0-12.9% of expectant women have GDM (Cho, 2013).Pregnant women who have gestational diabetes mellitus atomic number 18 more than likely to develop adverse pregnancy and child ancestry outco mes. Common maternal wellness complications are hypertensive affection (3.0-50.0%), preterm labour (2.0-14%), spontaneous abortion (3.5-25.3%), polyhydramnios (5.0-28.0%, and postpartum bleeding (6.0-10.5%). Neonatal complications include macrosomic infant (12.0-17.0%), congenital malformations (6.5-20.0%), shoulder dystocia (9.5-23.3%), birth dishonor (4.5-13.3%), respiratory distress syndrome (1.5-21.4%), hypoglycemia (20.0-68.5%), hyperbiliruninemia (5.3-48.3%), and admission in neonatal sell unit (15.0-20.6%) (Wang, 2013).These maternal and neonatal sequalae develop due to prolonged hyperglycemia. advanced levels of billet glucose can damage endothelial cells causing hypertensive disorder and its complications. Infants of pregnant women with GDM are also exposed to high maternal argumentation glucose levels (Webb, 2013).It is suggested that potencyling kin glucose within the recommended range (70-120 mg/dl) depart lessening these complications. GDM in pregnant women ca n be treated by medical examination nutrition therapy, insulin injection, and self-monitoring of telephone line glucose (American Diabetes Association, 2013). Testing of capillary blood for glucose levels is recommended as a diabetes self-management strategy.Pregnant women with GDM need to be discuss and taught to collect blood sample from their fingertip and use a glucometer to round blood glucose levels. Little is kn consume slightly their sensing and lived experience of self-monitoring of blood glucose. Understanding their perception and meaning regarding diabetes management will be useful to promote self-care, improve glycaemic sway, and decrease maternal and neonatal health complications.METHODSObjectives of the considerThe objectives of this playing field were to describe perceptions and meaning of lived experience in self-monitoring of blood glucose and utilization of blood glucose levels for glycaemic control among pregnant women who have gestational diabetes mell itus.Research designThis descriptive phenomenological study was designed to gain more understanding virtually lived experienced of pregnant women with gestational diabetes mellitus in self-monitoring of blood glucose. Specific qualitative research methods used in this study include bracketing the researcher perspectives, analyzing, intuiting, and describing perception and meaning of participants lived experience (Creswell, 2013 Touhyet al., 2013).Study settingThis study was conducted in the antenatal care units, diabetes clinics, and obstetric wards of two government hospitals in southern Thailand which are the referral centers providing advanced management of pregnancy complicated with GDM. estimable considerationThe research project and info collection procedures were approved by Institutional Review Boards and ethics committees of the Faculty of Nursing and Faculty of Medicine, Prince of Songkla University, and selected hospitals in southern Thailand.ParticipantsPotential par ticipants were approached and asked for participation by staff harbors. Informed live with was obtained by the researcher teams. Thirty pregnant women diagnosed with GDM during 24-30 week gestation were recruited for the study. entropy collectionData were collected using in-depth interviews following semi-structured interview guides. digital audio recording was used. The participants were asked to be interviewed at the antenatal clinic, diabetes clinic, or obstetric ward. Two interviews were conducted. Each interview took 30-45 minutes. Data were collected until saturation. Interview data were transcribed to prepare for coding and analyzing.Data analysisQualitative data were analyzed followingColaizzis method and included seven steps 1) rendition and re-reading descriptions, 2) extracting significant statements, 3) formulating the meaning of lived experiences in various contexts, 4) categorizing the meaning into clusters of beginnings, 5) describing the phenomenon being studied , 6) corroborative the decision with participants, and 7) incorporating informants view in the findings (Creswell, 2013).FINDINGSThe mean age of participants was 32.5 (22-39 years). Seventeen women were Buddhists and long dozen women were Muslims. Their educational levels were high school (6/30), vocational level (14/30), and bachelor power point (10/30). Most of them were multiparous (22/30) and were employed (18/30). Eight women had previous(prenominal) GDM and experience of self-monitoring of blood glucose. The findings showed three emerged etymons regarding perception and meaning of self-monitoring of blood glucose among pregnant women with GDM being hard-pressed about diabetes, trying to control it, and having patience for their child.Being dysphoric about diabetes comprised two dimensions wondering about the impact of diabetes on the child, and concern about maternal health. laterwards being informed that they had GDM, having high levels of blood glucose, they first thought abouthow diabetes would affect their pregnancy, particularly the heart and soul on their child. They believed that their infant would be harmed or malformed, or have diabetes. The participants perceptions regarding GDM impact on child health were as follows.Another dimension of being afraid of diabetes was concern over maternal health. Pregnant women having GDM were also concerned about complications during pregnancy much(prenominal) as abortion, preterm labour, and having diabetes after childbirth. They dual-lane their understanding as these words.The second theme was trying to control it. They gave two dimensions of trying to control diabetes that included 1) knowledge to foot race blood glucose, and 2) being aware of what to eat.Learning to test blood glucose. subsequently being diagnosed with GDM, diabetes nurse educators sure them about how to collect blood from the finger and use the glucometer to test blood glucose levels. Pregnant women needed to meet these immature skills of self-monitoring of blood sugar. They shared their experiences as follows.Being aware of what to eat. Pregnant women with GDM paid more attention to sprout slightly healthy victualss as recommended by doctors, nurses and dietitians. They learned to choose feed fount, portion size, and appropriate measure to have breakfast, lunch, dinner, and snacks between meals. They provided additional data as follows.The third theme was having patience for their child. Pregnant women with GDM uttered the meaning of their experiences of self-monitoring of blood glucose in two dimensions 1) overcoming food desires, and tolerating the fingerprick disoblige.The first meaning of having patience for the child was overcoming food desires. The women shared their experience of how they faced controlling their blood glucose. They had a struggle related to hunger due to cutting down on some favorite foods such as sweetened drinks, desserts and fruits. Sometimes they could not app ropriate their food desire, they then decided to eat what they wanted. This response supports the idea.The second dimension of having patience for their child was tolerating the fingerprick pain. After being diagnosed with GDM, they were advised to test their blood glucose by pricking the fingertip to collect capillary blood to measure blood glucose levels with a glucometer for 8 to 12 weeks. They experienced mild intensiveness of pain that they had to cope with in order to compass good glycaemic control. The women shared their tolerance with fingertip pain as follows.DISCUSSIONAfter being diagnosed with GDM, pregnant Thai women were worried about the impact of diabetes on their child and their own health. They were afraid that their child might have diabetes or other health problems, or even die. A previous study also imbed that women with GDM experienced fear about the wellbeing of their babies and themselves (Stankiewiczet al., 2014). For maternal health, most of them were wor ried about becoming diabetic later in life. The research recite revealed that women who had a history of GDM were at risk to develop prediabetes, diabetes, or metabolic syndrome. Among women with GDM, 5-14% were subsequently diagnosed with type 2 diabetes mellitus during the postpartum period and 7-29% had impaired glucose tolerance (Bihanet al., 2014).Pregnant women with GDM needed to learn to measure their blood glucose levels by self-monitoring technique. They express their experience as learning to test blood glucose because it was a new activity with which they had no skill and were not familiar. After being advised by diabetes nurse educators, they could collect a blood sample from the fingertip and test it with the glucometer. This result was supported the finding that women who have GDM can manage to control their blood glucose after they cope with emotional strain (Huiet al., 2014 Stankiewiczet al., 2014).In addition, the women had learned to control their blood glucose by being aware of what to eat. After receiving knowledge about diabetes medical nutrition therapy from a dietitian and nurse educator, they shared their understanding of prior dietary pattern that needed to be changed, such as reducing the consumption of sweetened drink and desserts, or fruit with high glycemic index. They had learned about the kind of foods for diabetes and portion sizes. They perceive that awareness of dietary behaviors was necessary to control their blood glucose levels. A previous study also reported that pregnant women with GDM changed their health behavior after being informed of their health problems andthe way to improve their health (Bandyopadhyayet al., 2011 Hjelmet al., 2012).Lastly, pregnant women with GDM shared their experiences that they were patient for their child. They had to overcome their food desires and cope with pain from fingertip pricking during blood testing. Normally, they had their favorite foods such as Thai fruits and desserts. After b ecoming pregnant with GDM, they had to adapt their food habits in order to achieve good glycemic control. Sometimes, they would like to eat something that they wanted but they were concerned about its impact on their child. Eventually, they decided not to eat that food or took only a small amount. However, some women could not resign their food desire and chose to take food to eat it for their satisfaction. After they fulfilled their need, they assay to practise as recommended. This was her voice In the afternoon, I felt thirsty. I tried to drink some water but it did not contact me. I continued to seek some sweetened drink that I like. I could not stop my desire, then I decided to take it. After that my blood sugar was as high as 215 mg/dl. I have learned what food raises my blood sugar. So I tried to face my feeling and overcome it for my child wellbeing and my health too.Another experience of having patience for the child was tolerating fingerprick pain. Pregnant women with GDM were advised to self-monitor their blood glucose 2 to 3 times a day, before or after meals, for 8 to 12 weeks until they gave birth. They had to cope with mild intensity of pain. They expressed their responses that they could do it in order to prevent health problems of their child and themselves. This supports the finding that perception that GDM affects behaviors related to maternal and child health and influences the adoption of a healthy lifestyle (Poth Carolan, 2013).Limitations of the studyLived experienced of self-monitoring of blood glucose in this study was obtained from the perspectives among pregnant women with gestational diabetes. It might not fit with the meaning and perception of individuals who have experience the management of type 1 or type 2 diabetes over a longer time.ConclusionsPregnant women being diagnosed with gestational diabetes mellitus had lived experienced characterized by two main themes being afraid of the effect of high blood glucose on their own he althand the impacts on their child, and trying to control blood sugar by being aware of what to eat, overcoming the food desires, responding to satiety, and tolerating to flake pricking. Understanding of the womens perception is useful to promote diabetes self-management.