The PICOT format is a guide to learning how to initiate research for evidence-based practice. It helps in breaking down the question into smaller understandable parts for better identification. The picot represents one, the affected population. Two of the remedies suggested for the problem. Three comparisons to other care providers, the outcomes of the researched results and finally, the period taken to provide the best care practice. In an attempt to identify and derive the answer to my query, I will determine the EBP sources in the web-based articles as well as journals to expound in the outcomes.
Define A Practice Issue to Be Explored Via A Picot Approach
The particular health care issue that was identified for resolve is the need to identify and develop a care plan tailored for the expectant mothered diagnosed of gestational diabetes in the home setting with both nutritional as well as diet-based approach. The research question under consideration is: Does implement dietary and lifestyle changes in pregnant clients with a new diagnosis of gestational diabetes (GDM), improve their blood sugar levels and have appropriately weight newborns within their gestational period?
The intervention measures would be dietary as well as lifestyle modification measures to assist in the control of the prepared patient's blood sugar levels and further decrease the chances of larger gestational age fetus, infections, unexpected abortion as well as hyperglycemia. The primary objective is to examine the lifestyle as well as dietary practices that address the subject matter, only elements in conjunction with the patient's home setting are also put into consideration. In breaking the picot, then we can understand what to do.
In (p), the population under consideration is identified, and we can understand the individuals that have been affected by the research question. However, before we can address (I), it is vital to research on the chance of the pregnant women being diagnosed it gestational diabetes. C will be used to compare which techniques are more effective in providing a solution for the issue, how, in this case, a research will be required to establish the effectiveness on the chosen technique. O is established in the preceding step as the resulting outcomes of the model employed as well as the resulting outcomes in the clinical practice.
Where researching the subject matter that is gestational diabetes in the expectant patients a variety of sources and sites were used to find an article related to GDM which include the google scholar database as well as the Capella university summons library, the first critical terms used in the research process include: "pregnancy complications as a result of gestational diabetes" "gestational diabetes", the modifiable risks arising from gestational diabetes", "nutrition and "gestational diabetes" as well as "gestational Diabetes diagnostics and treatment" (D & Paunikar, 2019). In the research process, I was very cautious only to make use of the advocacy resources and information to ensure creditable EBP data (Duarte-Gardea, et al., 2018). To ensure that the research question was adequately addressed, the research was further narrowed down to the research done on the subject matter with the last five years and only the prereview articles were used to assess the information concerning GDM, its modifiable risks as well as its treatment(Koivusalo, et al., 2015). And this resulted in creditable article sources that were five years old and below consisting of only prereview articles.
For any expectant lady or woman, the is always a lot of tests done in the first trimester which include the lab work as well as ultrasounds (Koivusalo, et al., 2015). However, it is essential to note that each of the lab work, as well as the ultrasound, are done at a specific gestational stage. When the fetus is 20 weeks old, and the lady has no prior history of diabetes, or have no modifiable risk factor. It is essential that she undergoes an infamous glucose test also primarily referred to as the glucose screen test/1-hr glucose tolerance test. The test consists of an hour of lab work that is usually tailored to establish how effectively the patient's body metabolizes glucose. If the finding from the lab reveals a level of below 135, then this means that the patient is not at risk of GDM but on the contrary if the result indicates levels of 135 -140, then the patient has to do an approximate of 3 hours of lab work. In the case that the patient fails their hours of love test glucose test, then the patient is diagnosed with gestational diabetes (D & Paunikar, 2019). In this instance, they have to follow a strict diet, also, to continually check on their level of glucose by pricking their fingers a couple of times daily and make a record of the results.
Additionally, the patient is required to make a record of the fetus kicks during the day and in extreme cases, use the insulin to control her blood sugar (Farabi & Hernandez, 2019). Gestational diabetes during pregnancy is a result of placental secretion home that impact glucose control or regulation. These hormones include the growth hormones, the lactogen hormones, the progesterone as well as corticotrophin-releasing hormone (Koivusalo, et al., 2015).
Since the placental secretion prevents the glucose from processing the body, the expectant patients then must make lifestyle changes; otherwise, the patient is most life to suffer severe complications during and after her pregnancy. Hence the patient needs to adjust her diet to a diabetic one. However, this is very challenging since the patient has been used to a different diet. However, this is important in reducing the chances of stillbirth, hyperbilirubinemia as well as the impaired lungs developing to the unborn baby. Before giving the patient a prescription for treating GDM, the first line for treatment is through nutritional therapy. Founded on the decade of clinical study and experiences on the way that diet was utilized in the treatment of diabetes outside the pregnancy section, the recommended contemporary plan for GDM is preferred to be restriction of dietary carbohydrate, i.e. CHO (Farabi & Hernandez, 2019). By altering the patient's dietary intake by reducing the CHO, it lowers the patient's risk of complications, for instance, the Pre-E, the rate of C-section as well as postpartum DM2.
The Relevance of The Findings
The selection of Koivusalo et al., 2016 was considered for this research paper since it provides critical statistical as well as data concerning the moderate lifestyle alterations on how it can decrease the incidences of GDM by approximately 39 percent in high-risk pregnancy. The study was conducted on a sample size of 293 females who had a prior past of GDM or and prior to pregnancy BMI of greater or equivalent to 30kg/m (D & Paunikar, 2019). The study population was enrolled for the study at less than 20 weeks of pregnancy, and they were then arbitrarily assigned to the intrusion population or the control population. Every individual in the controlled population received personal diet counselling, weight control as well as the physical activity from experienced study caregivers as well as had a single meeting with the dietician, additionally they received the antenatal care (Duarte-Gardea, et al., 2018). The study was aimed at assessing how complying with the lifestyle as well as how changes in a proper diet to incorporate healthier food can lower the chances of suffering from GDM and having the major health complication for not only the expectant mothers but for the fetus as well.
Additionally, the selection of the "Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis" is owing to the information that this article provides. It shows that the consumption of the fruit in pre-pregnancy has no link to GDM; on the contrary, an increased in potatoes intake had a substantial risk to GDM. Additionally, the increased intake in animals, cholesterol, as well as fatty acid increases the chances of GDM. However, proteins which are plant base lowers the probability of suffering from GDM. Patients or individuals with poor eating habits, for instance, a higher calorie diet as well as being smokers have a higher chance of developing the GDM and Pre-Eclampsia, which is defined as the increase blood pressure with proteinuria in am an expectant woman and increased amniotic fluid, stillbirths, macrosomia babies, birth injuries as well as infections. Further clinical evidence should be made available to determine the optimal technique for managing GDM. However, the article states that the early detection of GDM can assist in the prevention of complication during the prenatal period.
Creating a plan that can help expectant mothers diagnosed with GDM at the home setting by altering their dietary plan, exercise and makes changes to their lifestyle is feasible. The secrer4ete is education on early detection and prevention of GDM to avoid medications to control glucose levels and complications.
Farabi, S. S., & Hernandez, T. L. (2019). Low-Carbohydrate Diets for Gestational Diabetes. Nutrients, 11(8), 1737. doi: 10.3390/nu11081737
Duarte-Gardea, M. O., Gonzales-Pacheco, D. M., Reader, D. M., Thomas, A. M., Wang, S. R., Gregory, R. P., ... Moloney, L. (2018). Academy of Nutrition and Dietetics Gestational Diabetes Evidence-Based Nutrition Practice Guideline. Journal of the Academy of Nutrition and Dietetics, 118(9), 1719-1742. doi: 10.1016/j.jand.2018.03.014
D, R., & Paunikar, V. (2019). Maternal complications of gestational diabetes mellitus. National Journal of Physiology, Pharmacy and Pharmacology, (0), 1. doi: 10.5455/njppp.2019.9.0829631082019
Koivusalo, S. B., Rono, K., Klemetti, M. M., Roine, R. P., Lindstrom, J., Erkkola, M., ... Stach-Lempinen, B. (2015). Gestational Diabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL). Diabetes Care, 39(1), 24-30. doi: 10.2337/dc15-0511
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