Abstract
Objective To study the effect of individualized medical nutrition therapy ( MNT ) on nutrition metabolism of patients with gestational diabetes mellitus ( GDM) .Methods A total of 87 cases of GDM were selected as research objects .All these patients received MNT at the Department of Nutrition in Beijing Tongren Hospital Affiliated to Capital Medical University from January 2010 and July 2012. Over the same period , another 76 patients who did not undergo individualized MNT at the Department of Nutrition were chosen in control group.The treatment group was subdivided into two groups , namely the standard group and the substandard group .The standard group included 40 patients whose blood sugar levels met the standard while the substandard group was made up of 47 patients whose blood sugar levels were below the standard .When patients sought medical attention at the Department of Nutrition for the first time , their physical conditions at gestational weeks of 12 weeks were recorded .Besides, screening for diabetes mellitus was performed at their gestational weeks of 24 weeks.In addition, before delivery, various indicators were documented .Moreover, changes in indicators like fasting blood-glucose, blood sugar levels two hours post meal , serum total protein , serum albumin , hemoglobin , triglyceride and cholesterol before and after the treatment were compared .Results The research group had lower levels of fasting blood-glucose and blood sugar 2 hours post meal than those of the control group before delivery .However , the levels of hemoglobin and high-density lipoprotein cholesterol were higher in the research group than the control group .The preceding differences were of significant difference ( t value was 0.006, 0.039, 0.000, and 0.008, respectively, all P<0.05).In addition, the research group had higher levels of serum total protein , serum albumin, triglyceride, total cholesterol , and low-density lipoprotein cholesterol than the control group .However , the differences were not significant ( all P>0.05).No significant difference was identified between the standard subgroup and the substandard subgroup before delivery in the results of 7 indicators, namely the levels of hemoglobin, serum total protein, serum albumin, triglyceride, total cholesterol, low -density lipoprotein cholesterol and high -density lipoprotein cholesterol (all P>0.05).Comparing with the conditions when their files were set up, at the week before delivery , patients in the research group witnessed significant drop in fasting blood-glucose, blood sugar 2 hours post meal, total protein, and albumin and obvious increase in hemoglobin , triglyceride, total cholesterol, and low-density lipoprotein cholesterol.The preceding differences were significant (t value was 2.185, 1.152, -1.244, 2.185, 1.976, -1.865, -1.532, and-0.567, respectively, all P <0.05).Although the level of high -density lipoprotein cholesterol elevated , the difference was not significant (P>0.05).Conclusion MNT can effectively improve the glucose metabolism of GDM patients , prevent, and cure anemia during pregnancy .However , its effect on lipid metabolism is very limited .Physiological changes during pregnancy are the leading causes of lipid metabolic changes .Therefore, the former approach of using lipid metabolism to assess the effects of MNT during gestation period might be wrong .关键词
妊娠糖尿病/个体化营养治疗/血糖/血脂Key words
gestational diabetes mellitus ( GDM)/individualized nutritional therapy/blood sugar/blood lipid分类
医药卫生
