Abstract
Objective:Gestational diabetes mellitus(GDM)increases the risk of adverse maternal and neonatal outcomes.This study aims to manage pregnant women with GDM using a low glycemic index(GI)diet combined with a personalized exercise program to improve glycemic control and reduce adverse outcomes in both mothers and newborns.
Methods:A total of 88 pregnant women diagnosed with GDM and treated at the Department of Obstetrics,Second People's Hospital of Beihai,from March 2023 to March 2024 were prospectively enrolled.The control group(n=43)received routine care,whereas the observation group(n=45)received low-GI dietary management and personalized exercise interventions in addition to routine care.All interventions continued from admission until delivery.Baseline characteristics were recorded,and fasting plasma glucose(FPG),1-hour postprandial glucose(1hPG),2-hour postprandial glucose(2hPG),glycated hemoglobin A1c(HbA1c),fasting C-peptide(FCP),2-hour postprandial C-peptide(2hPCP),and homeostatic model assessment of insulin resistance(HOMA-IR)were measured before and after intervention.Lipid indices,including total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were measured,and systolic(SBP)and diastolic blood pressure(DBP)were recorded before and after intervention.Post-intervention maternal adverse pregnancy outcomes,neonatal adverse outcomes,patient satisfaction,dietary compliance,and exercise compliance were assessed and analyzed.
Results:There were no significant differences in baseline characteristics between the 2 groups(all P>0.05).Before intervention,blood pressure and lipid levels were comparable(all P>0.05).After intervention,FPG,1hPG,2hPG,HbA1c,TC,DBP,and SBP in the observation group were significantly lower than those in the control group(all P<0.05),while HDL-C was significantly higher(P<0.05).Compared with pre-intervention values,the observation group showed significant reductions in FPG,1hPG,2hPG,HbA1c,TC,HDL-C,DBP,and SBP(all P<0.05).Pre-intervention insulin function parameters did not differ significantly between the 2 groups(all P>0.05).After intervention,FCP and HOMA-IR in the observation group were significantly lower than those in the control group(both P<0.05),and FCP,2hPCP,and HOMA-IR were significantly reduced from pre-intervention levels(all P<0.05).The observation group had significantly fewer cases of overall adverse pregnancy outcomes,low-birth-weight infants,and overall adverse neonatal outcomes compared with the control group(all P<0.05).Overall nursing satisfaction was significantly higher in the observation group(P<0.05).Dietary compliance,including self-regulated eating,adherence to sugars and fats,and adherence to guidelines for oil and salt intake,was significantly higher in the observation group(P<0.05).Exercise compliance,including reaching prescribed exercise volume,meeting daily exercise frequency,and achieving required exercise duration,was also significantly higher(all P<0.05).
Conclusion:A low-GI diet combined with personalized exercise interventions can improve blood glucose,lipid profiles,blood pressure,and insulin function in pregnant women with GDM,and significantly reduce adverse maternal and neonatal outcomes.Compliance with low-GI dietary and personalized exercise interventions is superior.Low-GI diet and personalized exercise programs may be considered in clinical decision-making for GDM management.关键词
低血糖指数饮食/个性化运动/妊娠糖尿病/血糖/不良结局Key words
low glycemic index diet/personalized exercise/gestational diabetes mellitus/blood glucose/adverse outcomes
