Scene-Based-Reflection (SBR2)

 SBR 2

Seorang ibu mengandung berumur 37 tahun, dengan umur kandungan 32 minggu telah pergi ke klinik kesihatan ibu dan anak untuk pemeriksaan kesihatan. Beliau ke klinik ditemani oleh suaminya. Pemeriksaan kesihatan mendapati Ibu ini telah didiagnos dengan kencing manis. Suami beliau yang juga seorang pesakit diabetes mellitus jenis 2 merasa risau dengan diagnosis tersebut. Pada pendapat si suami; kerisauan ini kerana tidak mahu anak dalam kandungan “dijangkiti” penyakit tersebut dan seterusnya perlu mengambil ubat seumur hidup.

Diabetes mellitus Type 2	The body's capacity to manage and utilise sugar (glucose) is impaired. A high blood sugar level is caused by this long-term (chronic) sickness. Hyperglycaemia can cause difficulties with the circulatory, neurological, and immune systems in the long term. Because the pancreas does not produce sufficient insulin (a hormone that regulates the amount of sugar entering cells) and cells do not behave properly to insulin, sugar uptake is lowered.
Factors increase risk of Type 2 diabetes mellitus	Weight Obesity or being overweight is a major risk factor. The diffusion of fat Fat storage mostly in the belly, instead of the hips and thighs, implies a higher risk.  If you're a guy with a waist circumference of more than 40 inches or a woman with a waist of more than 35 inches, more likely to develop type 2 diabetes. Inactivity The lower your level of activity, the higher your chance. Physical activity promotes weight loss by burning glucose for energy and creating the cells highly insulin sensitive. History of the family  If your close family member has type 2 diabetes, you're more likely to develop the disease. Lipids levels in the blood Decreased amounts of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) and elevated levels of triglycerides are associated with a greater risk. Age And when you get older, your chance of developing Type 2 diabetes rises, particularly after the age of 45. Risks associated with pregnancy.  If you had gestational diabetes while pregnant or went into labour with a kid weighing more than 9 pounds, you're more prone to diabetes (4 kg). Polycystic ovarian syndrome (PCOS) is a kind of polycystic ovary syndrome Polycystic ovarian syndrome, a common disorder marked by irregular menstrual cycles, excessive hair growth, and obesity, raises the chance of developing diabetes.
Complications of diabetes mellitus	Mother Preeclampsia (high blood pressure, extra proteins in the urine, leg/feet edoema) in the mother, increased risk of gestational diabetes in subsequent pregnancies, and increased risk of diabetes later age. New born  Increased birth mass, low blood sugar (hypoglycemia) in the baby, increased chance of getting Type 2 diabetes over time, and mortality shortly after delivery.
Diagnosis of diabetes mellitus	Fasting plasma glucose test This test is most effective when performed in the morning following an eight-hour fast (nothing to eat or drink except sips of water). Random plasma glucose test This test can be performed at any time and does not need fasting. A1c test This test measures your overall blood glucose level over the past two to three months and is also recognized as HbA1C or glycated haemoglobin testing. The amount of glucose attached to haemoglobin, the oxygen-carrying protein in your red blood cells, is evaluated by this test. There is no need to fast before this exam. Oral glucose tolerance test  Following a 8-hour period, this test analyses blood glucose levels. After that, you drink a sweet beverage. Then, at hours one, two, and three, your blood glucose level is examined.
Gestational diabetes mellitus	When the body doesn't produce enough insulin during pregnancy, gestational diabetes emerges. Insulin, a hormone generated by the pancreas, allows your body use sugar for energy and regulate blood glucose levels in balance. The body creates unique hormones and goes experience several changes during pregnancy, such as weight gain. The body's cells become resistant to insulin as a result of these alterations. Insulin resistance affects all pregnant mothers at some point throughout their pregnancy. Whereas the majority of pregnant women may produce enough insulin to combat insulin resistance, others cannot. This group of pregnant women suffers gestational diabetes.
Effect of Gestational Diabetes mellitus	Diabetes mellitus during pregnancy has a variety of negative consequences for the mother, including an elevated risk of cardiovascular disease and type 2 diabetes, as well as macrosomia and childbirth problems in the newborn. Obesity, type 2 diabetes, and cardiovascular disease are all long-term risks for the newborn. Although insulin does not penetrate the placenta, other substances such as glucose do. As a result, more blood glucose passes through the placenta, resulting in elevated blood glucose levels in the newborn. To get removal of the blood glucose, the baby's pancreas produces more insulin. The excess energy is stored as fat because the infant is receiving more energy than it requires to grow and develop. This can result in macrosomia, or an "overweight" infant. Macrosomia babies have their own set of health issues, including shoulder injury at birth.
Treatment For  Gestational Diabetes mellitus	Monitoring your blood glucose levels to ensure they remain within a safe range. Insulin injection Insulin lispro, aspart, and detemir are approved to be used in pregnancy in which functions to regulate blood sugar levels and store excess glucose as energy. Eating the correct kinds of healthful foods at the appropriate times.  Follow your doctor's or dietitian's appropriate dietary advice. Being active is important.  Regular moderate-intensity physical exercise (such as light exercise) drops blood sugar and enhances insulin sensitivity, allowing your body to need little insulin. Check with your doctor to see what kind of physical exercise you can participate in and which ones you might prevent. Keep an eye on your child.  Your baby's growth and development will be monitored by your doctor.
Inheritance	Type 2 diabetes is more strongly linked to genetic history and ancestry than type 1, and several studies have found a significant genetic component in type 2 diabetes generation. The risk of type 2 diabetes raises as the quantity of diabetic family members raises. The increased risk is most likely due to shared genetic factors, but it is also linked to shared lifestyle influences (such as eating and exercising behaviours) among members of the family.