Diabetes in Hispanic Women during Pregnancy - Research Paper Example

?Running Head: health sciences and medicines Diabetes in Hispanic Women during Pregnancy of the of the of the Professor] [Course] Introduction The assignment aims at discussing the prevalence of diabetes in Hispanic Women during pregnancy IN THE LOS ANGELES AREA. For this purpose, research conducted by Xiang, et al (2010) on the prevalence of diabetes in Hispanic women has been chosen that has been published in American Diabetes Association (American Diabetes Association (2004). The critical analysis of the research has been presented under different sub heads that has been discussed in an illustrative manner. Problem Definition The diagnosis of gestational diabetes mellitus aims at identifying young women without traced diabetes having circulating glucose concentrations especially during pregnancy. These Hispanic women have the possibility of developing diabetes and are at a risk level of 20-60%. Thus, the research offers an opportunity to study the reason behind the chances of diabetes amongst diabetes women during pregnancy by assessing physiological, psychological educational, economic and living standard factors in a critical manner. There is no denying that diabetes has been considered as one of the most common diseases affecting the overall health. The identified problem will help in understanding the overall prevalence of diabetes in Hispanic Women in Los Angeles. Description of Agent Glucose level plays an important role in the development of diabetes. Cross sectional studies conducted on the level of glucose concentrations conducted during and after pregnancy revealed that women with gestational diabetes mellitus have more insulin resistance and less pancreatic ?-cell resistance compared to women who maintain normal level of glucose resistance during and after pregnancy. Thus, it can be said that glucose level plays an important role as an agent in the development of diabetes amongst everyone and especially amongst women during and after pregnancy. It is important to analyse the resistance level of glucose at every step in order to keep a tab on the development of diabetes (Kim, et al, 2002) Description of Condition Glucose level plays an important role in the development of diabetes and it needs to be controlled. In this study conducted by Xiang, et al (2010) on the prevalence of diabetes in Hispanic women has been chosen that has been published in American Diabetes Association (American Diabetes Association (2004), it was found that glucose level rises slowly till the compensation reaches low level. At that time, glucose may reach to the higher level and into the diabetic range that can cause diabetes during and after pregnancy. The baseline testing (blood test fasting, random, and HA1c) helps in identifying the deterioration level along with examining the impact and influence of such factors that enhance the overall glucose level. The study showed that in Hispanic Women ?-cell compensation for insulin resistance falls at a great speed after five years of pregnancy. Moreover, women with gestational diabetes mellitus have more insulin resistance and less ?-cell resistance that complicates the entire issue along with increasing the chances of diabetes in the short as well as in the long run. It can be said that the condition being analyzed in the study is not very much critical but searches for scientific and clinical trials in order to assess and identify the overall development of diabetes during and after pregnancy amongst Hispanic women. Description of Host Characteristics Host characteristics plan an important role in understanding few demographic factors like age, sex, location and ethnicity. Moreover, while conducting a study on a particular group revolving around prevalence of diabetes during pregnancy, it is important to identify these characteristics. These characteristics are as follow: Age- the age of participants has not been disclosed but women with gestational period of 28 and 34 weeks were allowed to be part of the study. In case of not mentioning the age, there is not going to have too much of an impact on the overall analysis considering the fact that the discussion aims at identifying the prevalence of diabetes during diabetes. However, study conducted by Taber et al (2010) stated that the average age of Hispanic women was 24.3. Sex- All participants were pregnant women on whom tests were conducted to identify the level of insulin and ?-cell resistance leading to diabetes during and after pregnancy. Nativity- the nativity of women was not disclosed and it is difficult to state their native place. However, their ethnic group has been revealed that highlights the overall prevalence of a disease in Hispanic Women Marital Status- Marital status of pregnant women has not been disclosed. However, other researches like one being conducted by Taber, et al (2010) states that women with high acculturation were less likely to live with a partner and 87% were not married. Ethnic Group- the ethnic group is Latino where pregnant women have been tested and studied in terms of glucose and ?-cell resistance level in a scientific, clinical and logical manner. Description of Environmental Attributes Environmental attributes encompass factors like geographical area, income, living standard, occupation and education of participants. There is no denying that all these factors play an important role in identifying the impact and influence of a particular disease. Some of the key environmental attributes are as follow: Geographical Areas- though not much have been highlighted in terms of geographical area of participants but it has been stated that majority of them were from Los Angeles and New York reporting to Los Angeles County Women Hospital. Social and Economic Factors- It needs to be mentioned that demographic factors play an important role. However, no information has been reveled in the research conducted by Xiang, et al (2010) on the prevalence of diabetes in Hispanic women but research conducted by Taber, et al (2010) on the similar subject states that Hispanic women belonged to low income group but were involved in walking and moderate physical activities. Occupation- Nothing has been mentioned on the education of participants in the research conducted by Xiang, et al (2010) but the research conducted by Taber, et al (2010) on the similar subject states that 632 women belonged to low income group with no job or prior job experience. Education- Another research conducted by Taber, et al (2010) states that 632 women participants belonged to low income group with not even a college degree that somehow affected their learning in terms of understanding the health behaviour. Temporal Variation Temporal variation signifies the happening of a phenomenon. It may be secular, cyclic, seasonal and epidemic. The detail information on every element is as follow: Secular- Secular changes happen very slowly in a long period of time. In this study, diabetes changes have been assessed for a period of five years that cannot be considered as a long period of time and thus the variation cannot be termed as secular. Cyclic- Cyclic changes happen over a period of time in the short as well as in the long run. The changes highlighted in the study reveals that diabetes can happen in the short as well as in the long run depending on the resistance of glucose level and ?-cell resistance and thus can be considered as a cyclic variation. Seasonal- seasonal variations are dependent on seasons. It needs to be mentioned that diabetes is not affected by any season and does not develop in a particular season. Thus, it is important to eliminate this variation in the context of the study. Epidemic- Epidemic signifies an outbreak of an infectious disease that affects large number of people. However, diabetes cannot be considered as such disease and does not affect large number of people in a particular period. Thus, epidemic variation can also be eliminated in the context of the study. Additional Epidemiologic In the study conducted by Xiang, et al (2010) on the prevalence of diabetes in Hispanic women has been chosen that has been published in American Diabetes Association (American Diabetes Association (2004), basically glucose resistance level and ?-cell resistance level has been discussed along with identifying an increase and decrease in them leading to diabetes in the short as well as in the long run. On the other hand, hypertension and obesity also plays an important role in developing and aggravating diabetes and should be controlled in order to control diabetes during and after pregnancy or at any stage of life (Xiang, et al, 2006). This will help in controlling it in an effective and efficient manner. Summarizing Current Hypotheses Three clinical variables weight gain, glucose intolerance and metabolic deterioration offered information on the risk of diabetes during gestational diabetes mellitus. Weight gain can be considered as the biggest factor for affecting the rise of insulin resistance and ?-cell resistance amongst the Hispanic women. The factors include chronic glucose intolerance that is detected by glucose screening. Women with high level of glucose and worst ?-cell resistance tend to develop diabetes compared to other women. Metabolic deterioration that is a metabolic disorder occurring due to the chemical reaction in the body also affects the overall prevalence of diabetes in the short as well as in the long run and should be assessed at regular level through checkups and tests (Buchnan, et al, 2004) Gaps in Knowledge The study has been conducted in a logical and systematic manner leaving very little gap in terms of knowledge and findings. Women referred to Los Angeles County Women’s Hospital for the management of GDM between the period of 1993-1995. All subjects gave their written consent for participating in the study which was also approved by the Institutional Review Board of the University of South California and the Los Angeles County Medical Association. Subjects were assessed on glucose level, body composition and diet pattern. Women were also tested during the pregnancy and after pregnancy period in order to identify the prevalence of diabetes. Moreover, 72 women met the criteria for undergoing the test and research and out of these, 60 women have their baseline visit at 15 months and 12 had their visit after 30 months. In between these periods, glucose results were analyzed along with keeping a close eye on body weight and diet pattern. This helped in understanding the development pattern of diabetes. Overall, it can be said that the study does not have any significant gap other than not highlighting demographic, environmental and social factors that would have helped in understanding the impact of these elements in a significant and logical manner. Other than this, the study does not offer any loophole or gap that needs attention and criticism. It is important to identify key factors playing important role in gestational diabetes amongst Hispanic Women and for this purpose research should be conducted on Hispanic Women only from a particular city along with classifying the marital status and other demographic and social factors in a clear manner. Suggestions for Further Research The research conducted by Xiang, et al (2010) has been presented in a logical and illustrative manner highlighting the importance and assessment of diabetes amongst Hispanic Women during and after pregnancy. However, the study includes during and after pregnancy results pertaining to diabetes that can be a cumbersome task to understand. Moreover, the period of analysis and assessment is too long that can offer different results. The number of participants can be considered as reasonable offering good amount of scope to conduct the study. However, in order to enhance the overall study, it is important to include other factors like demographic factors of Hispanic Women along with assessing environmental and social factors that play an important role in the development of diseases This will also help in understanding the overall impact of diet pattern and lifestyle that plays an important role in the development of diabetes in the present as well as in the future (Weyer, et al, 2000) The next suggestion is to assess and test women who are pregnant for a period of one year in order to understand the impact and influence of certain agents. After closely analyzing the period of one year, things will be clear on how diabetes affect the overall health condition during pregnancy. After that tests and studies can be conducted for post pregnancy period that will help in assessing the development of diabetes after pregnancy considering the fact that weight increases during pregnancy and decreases after pregnancy based on diet pattern and other factors. All these initiatives will help in analyzing the development of diabetes amongst Hispanic women in a logical and illustrative manner along with offering concrete results and outcomes that can be used to understand the overall phenomenon. The next part of the analysis talks about the quality and adequacy of statistical data in a critical and illustrative manner that often plays an important role in achieving the objectivity of the research. Quality/Adequacy of Statistical Data The quality and adequacy of statistical data can be considered as quite refined and illustrative as the research work has been published by the American Diabetes Association. The data highlight baseline characteristics like age, body percentage fat, body weight and other information while rate of changes highlight changes in weight and glucose level over a period of time. Baseline predictors of diabetes like decrease in weight, Body Mass Index (BMI), age, heart rate and cholesterol also present a critical understanding of wide arrays of factors playing an important role in the development of diabetes (Xiang, et al, 2010). The assessment of clinical variables has been presented in the tabular form highlighting the impact and influence of each variable. Overall, it can be assumed that the quality, adequacy and effectiveness of statistical data is quite impressive and logical enough to understand the purpose of the research in an effective manner. All information and results have been presented using graphs, charts and statistical data that helped in understanding the chances of the occurrence of diabetes during and after pregnancy. Quality/Adequacy of Literature Citation The literature used in conducting the research is based on the research topic and can be considered as good enough to assist the research topic. Most literatures are based on gestational diabetes that is the core area of the research along with few on the importance of glucose level in the development of diabetes during and after pregnancy. The article based on the research conducted by Xiang, et al (2010) on the prevalence of diabetes in Hispanic women has been chosen that has been published in American Diabetes Association (American Diabetes Association (2004published by American Diabetes Association on classification and diagnosis of diabetes can be considered as of great help while the research work of Xiang, et al (1999) and Peters et al (1996) on development of diabetes during and after pregnancy can be considered as of great insight in analyzing the overall study. Overall, it can be assumed that the quality and adequacy of the literature used is good enough to assist the entire study in a significant manner along with understanding the overall impact and influence of diabetes on Hispanic Women during and after pregnancy in the short as well as in the long run. Overall Evaluation of the Paper The overall paper has been presented in a critical manner with entire focus on assessing the impact and influence of diabetes during and after pregnancy amongst Hispanic Women. The data analysis has been presented in an informative and illustrative manner using graphs and charts. The analysis has been divided into different parts covering variety of information on problem area, description of agent, description of host, environmental factors, temporal variations, hypotheses, analysis of gap and effectiveness of literature and overall research. The analysis also highlights the overall limitation of the research in a significant manner along offering suggestions in a logical manner. The presentation has been kept simple and descriptive that allows reader to understand the purpose and importance of the topic in a clear and transparent manner. It can be said that the paper would have been more concrete by highlighting information on demographic and social factors. This would have helped in assessing the influence of these factors in the development of diabetes amongst Hispanic women. However, the overall flow of communication is good enough to offer good amount of information that has been analyzed and presented in a logical and descriptive manner. References American Diabetes Association (2004), Diagnosis and classification of diabetes mellitus. Diabetes Care, 27(Suppl. 1):S5–S10 Retrieved March. 26, 2012, from the World Wide Web: http://www.ncbi.nlm.nih.gov/pubmed/14693921 Buchanan TA, Xiang AH, Peters RK, Kjos SL, Marroquin A, Goico J, Ochoa C, Tan S, Berkowitz K, (2002), Hodis HN, Azen SP. Preservation of pancreatic B-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk Hispanic women. Diabetes; 51:2796–2803, Retrieved March. 26, 2012, from the World Wide Web: http://www.ncbi.nlm.nih.gov/pubmed/12196473 Kim C, Newton KM, Knopp RH (2002). Gestational diabetes and the incidence of type 2 diabetes. Diabetes Care, 25:1862–1868, Retrieved March. 26, 2012, from the World Wide Web: http://www.ncbi.nlm.nih.gov/pubmed/12351492 Taber, L, Fortner,R, Gollenberg, A,Buonnaccorsi,J, Dole,N (2010). A Prospective Cohort Study of Modifiable Risk Factors for Gestational Diabetes among Hispanic Women: Design and Baseline Characteristics. 117–124. , Retrieved March. 26, 2012, from the World Wide Web: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828256/ Weyer C, Hanson K, Bogardus C, Pratley R (2000). Long-term changes in insulin action and insulin secretion associated with weight gain, loss, regain and maintenance of body weight. Diabetologia, 43:36–46, Retrieved March. 26, 2012, from the World Wide Web: http://www.ncbi.nlm.nih.gov/pubmed/10663214 Xiang, et al (2010): Detailed Physiological Characterization of the Development of Type 2 Diabetes in Hispanic Women with Prior Gestational Diabetes Mellitus, Accessed from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279539/ Xiang A, Peters RK, Kjos SL, Marroqiun A, Goico J, Ochoa C, Kawakubo M, Buchanan TA (2006). Effect of pioglitazone on pancreatic ?-cell function and diabetes risk in Hispanic women with prior gestational diabetes. Diabetes, 55:517–522. Retrieved March. 26, 2012, from the World Wide Web: http://www.ncbi.nlm.nih.gov/pubmed/16443789 Appendices Prevalence Charts Xiang, et al (2010): Detailed Physiological Characterization of the Development of Type 2 Diabetes in Hispanic Women with Prior Gestational Diabetes Mellitus ,Baseline Characteristics of Diabetes, Retrieved March. 26, 2012, from the World Wide Web http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279539/ Xiang A, Peters RK, Kjos SL, Marroqiun A, Goico J, Ochoa C, Kawakubo M, Buchanan TA (2006). Effect of pioglitazone on pancreatic ?-cell function and diabetes risk in Hispanic women with prior gestational diabetes. Diabetes, 55:517–522. Retrieved March. 26, 2012, from the World Wide Web: http://www.ncbi.nlm.nih.gov/pubmed/16443789 Xiang, et al (2010): Detailed Physiological Characterization of the Development of Type 2 Diabetes in Hispanic Women with Prior Gestational Diabetes Mellitus, Baseline predictors of Diabetes, Retrieved March. 26, 2012, from the World Wide Web http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279539/ Xiang, et al (2010): Detailed Physiological Characterization of the Development of Type 2 Diabetes in Hispanic Women with Prior Gestational Diabetes Mellitus, Baseline disposition Index, Retrieved March. 26, 2012, from the World Wide Web http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279539/ Read More