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妊娠期糖尿病患者个体化营养干预效果研究OACSTPCD

Study on Individualized Nutritional Intervention in Patients with Gestation-al Diabetes Mellitus

中文摘要英文摘要

目的 探讨个体化营养干预对妊娠期糖尿病患者血糖控制及妊娠期并发症、不良妊娠结局的影响.方法 选取2020 年1-12 月就诊并在医院建档行定期孕检的妊娠期糖尿病120 例,根据干预方法不同将其分为研究组和对照组,2 组各60 例.研究组给予个体化营养干预,对照组给予常规干预.观察并比较 2 组妊娠期糖尿病干预前及干预后空腹及餐后2h血糖、空腹胰岛素、胰岛素抵抗指数及妊娠期并发症、不良妊娠结局.结果 干预前,2 组妊娠期糖尿病空腹及餐后2h血糖、空腹胰岛素、胰岛素抵抗指数等指标比较无统计学差异(P>0.05).干预后,研究组妊娠期糖尿病空腹及餐后 2h血糖和空腹胰岛素、胰岛素抵抗指数水平均低于干预前以及对照组以上指标(P<0.01).研究组妊娠期糖尿病妊娠期高血压、巨大儿和新生儿低血糖的发生率(2/60,3.33%;3/60,5.00%;3/60,5.00%)亦低于对照组(11/60,18.33%;13/60,21.67%;12/60,20.00%)(P<0.05).结论 个体化营养干预在稳定妊娠期糖尿病患者空腹及餐后2h血糖、改善空腹胰岛素及胰岛素抵抗指数方面效果良好,并且可降低妊娠期并发症及不良妊娠结局发生率.

Objective To explore the effect of individualized nutritional intervention on blood glucose control,preg-nancy complications and adverse pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods From December 2020 to December 2022,120 GDM patients who visited the hospital and underwent regular prenatal check-ups were divided into the research group(n=60)and the control groups(n=60).The research group received individualized nutri-tional intervention,while the control group received conventional intervention.Fasting blood glucose,2-hour postprandial blood glucose(2 hPBG),fasting insulin,insulin resistance index,as well as pregnancy complications,and adverse pregnan-cy outcomes,were observed and compared in both groups before and after intervention of GDM.Results Before intervention,there was no significant difference in the fasting blood glucose,2hPBG,fasting insulin and insulin resistance index between the two groups(P>0.05).After intervention,the fasting blood glucose,2 hPBG,fasting insulin and insulin resistance index were lower in the research group than those before intervention of GDM,which were lower than those in the control group(P<0.01).The incidence of gestational hypertension,macrosomia and neonatal hypoglycemia in the research group(2/60,3.33%;3/60,5.00%;3/60,5.00%)was lower than that of the control group(11/60,18.33%;13/60,21.67%;12/60,20.00%)(P<0.05).Conclusion Individualized nutritional intervention is effective in stabilizing fasting blood glu-cose and 2 hPBG,improve fasting insulin,and insulin resistance index in patients with GDM,which can reduce the incidence of pregnancy complications and adverse pregnancy outcomes.

滑丽美;辛红;苑雪娇;胡丽叶;李丽君;王雅兰

050000 石家庄,解放军联勤保障部队第九八〇医院营养科050000 石家庄,河北医科大学第二医院妇产科050000 石家庄,河北医科大学第二医院全科医学科050000 石家庄,解放军联勤保障部队第九八〇医院内分泌科

临床医学

糖尿病,妊娠营养干预空腹血糖餐后2h血糖空腹胰岛素胰岛素抵抗指数妊娠期并发症不良妊娠结局

Diabetes,gestationalNutritional interventionFasting blood glucose2-hour postprandial blood glu-coseFasting insulinInsulin resistance indexPregnancy complicationsAdverse pregnancy outcomes

《临床误诊误治》 2024 (004)

47-51 / 5

河北省医学重点课题(20200251)

10.3969/j.issn.1002-3429.2024.04.010

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