Volume 19 Issue 4
Apr.  2021
Turn off MathJax
Article Contents
DU Zhi-mei, NI Yan, JIANG Ruo-an, CHEN Dan-qing. Effect of early pregnancy medical nutrition therapy on blood glucose, weight control, maternal and infant outcomes and medical compliance in gestational diabetes mellitus[J]. Chinese Journal of General Practice, 2021, 19(4): 617-620. doi: 10.16766/j.cnki.issn.1674-4152.001876
Citation: DU Zhi-mei, NI Yan, JIANG Ruo-an, CHEN Dan-qing. Effect of early pregnancy medical nutrition therapy on blood glucose, weight control, maternal and infant outcomes and medical compliance in gestational diabetes mellitus[J]. Chinese Journal of General Practice, 2021, 19(4): 617-620. doi: 10.16766/j.cnki.issn.1674-4152.001876

Effect of early pregnancy medical nutrition therapy on blood glucose, weight control, maternal and infant outcomes and medical compliance in gestational diabetes mellitus

doi: 10.16766/j.cnki.issn.1674-4152.001876
Funds:

 2018C03010

 2019ASA90192

  • Received Date: 2020-11-26
    Available Online: 2022-02-16
  •   Objective  This study aimed to investigate the effect of medical nutrition therapy (MNT) on blood glucose, body weight and pregnancy outcome of pregnant women with gestational diabetes mellitus (GDM).  Methods  A total of 100 cases of pregnant women with GDM in the first trimester of pregnancy (3 months of pregnancy), who were admitted in our hospital obstetrics department from January to December 2018 for clinical observation, were included in this study. On the basis of the random number table method, the patients were divided into two groups, 50 cases in each group. The control group received routine pregnancy examination, diet guidance and blood glucose control during pregnancy, whereas the observation group received individualised MNT regimen on the basis of routine pregnancy examination. Weight gain during pregnancy (total weight gain, the proportion of abnormal weight gain), blood glucose control results (fasting blood glucose, 2 h blood glucose after breakfast, lunch and dinner, glycosylated haemoglobin), compliance rate (strict diet control, regular blood glucose monitoring, reasonable aerobic exercise and weight control) and the incidence of pregnancy complications related to glucose metabolism (gestational hypertension, dyslipidaemia during pregnancy and delivery of giant newborns) were compared between the two groups.  Results  After 3 months of intervention, the results of blood glucose control in the observation group were better than those in the control group, with significant difference between the two groups (all P>0.05). The total weight gain and abnormal weight gain ratio in the observation group were lower than those in the control group (all P < 0.05). The improvement of compliance rate with strict control of diet and regular monitoring of blood sugar in the control group (70.0%, 76.0%) was better than that in the observation group (86.0%, 90.0%; all P>0.05). The improvement of compliance rate with reasonable aerobic exercise and weight control in the observation group (88.0%, 84.0%) was better than that in the control group (70.0%, 66.0%; all P < 0.05). The incidence of abnormal blood lipid in the delivery group was lower than that in the control group (P < 0.05).  Conclusion  Individualised MNT in early pregnancy can change the compliance rate of women with GDM, control weight gain during pregnancy and reduce the incidence of adverse pregnancy outcomes. Therefore, MNT in early pregnancy has potential clinical application.

     

  • loading
  • [1]
    MOKKALA K, VAHLBERG T, PELLONPERǍ O, et al. Distinct metabolic profile in early pregnancy of overweight and obese women developing gestational diabetes[J]. J Nutr, 2020, 150(1): 31-37. doi: 10.1093/jn/nxz220
    [2]
    ERKAMP J S, GEURTSEN M L, LIESBETH D, et al. Associations of maternal early-pregnancy glucose concentrations with placental hemodynamics, blood pressure, and gestational hypertensive disorders[J]. Am J Hypertens, 2020, 33(7): 660-669. doi: 10.1093/ajh/hpaa070
    [3]
    LIU B, CAI J, XU Y, et al. Early diagnosed gestational diabetes mellitus is associated with adverse pregnancy outcomes: a prospective cohort study[J]. J Clin Endocrinol Metab, 2020, 105(12): dgaa633. http://www.researchgate.net/publication/344204907_Early_Diagnosed_Gestational_Diabetes_Mellitus_Is_Associated_with_Adverse_Pregnancy_Outcomes_A_Prospective_Cohort_Study
    [4]
    王静, 沈山梅. 妊娠期糖尿病的医学营养治疗[J]. 中国实用内科杂志, 2018, 38(6): 531-534. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201806012.htm
    [5]
    孙桂丽, 王彩珊, 卢连, 等. 个性化医学营养治疗对妊娠期糖尿病患者血糖及母婴并发症的影响[J]. 广西医学, 2018, 40(18): 2169-2172. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX201818011.htm
    [6]
    王雅萍, 汤琳琳, 雷磊, 等. 妊娠期糖尿病患者孕前BMI与血糖及膳食营养摄入的相关性分析[J]. 现代生物医学进展, 2019, 19(15): 2884-2886, 2844.
    [7]
    郭玉蝉, 张巧璇. 妊娠早中期个体化医学营养管理对降低妊娠期糖尿病发生率的作用研究[J]. 河北医药, 2018, 40(5): 762-764. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ201805031.htm
    [8]
    WONG T, BARNES R A, ROSS G P, et al. Are the Institute of Medicine weight gain targets applicable in women with gestational diabetes mellitus?[J]. Diabetologia, 2017, 60(3): 416-423. doi: 10.1007/s00125-016-4173-3
    [9]
    崔铭萱, 吕净, 蔡晶晶, 等. 孕早期医学营养治疗对妊娠期糖尿病高危妊娠女性体重及血糖代谢并发症的影响[J]. 中国医刊, 2019, 54(4): 439-442. doi: 10.3969/j.issn.1008-1070.2019.04.026
    [10]
    吴贤菊, 石华, 董晨, 等. 妊娠期糖尿病PDCA循环管理及个体化医学营养治疗对患者体重及血糖控制、新生儿出生体重的影响[J]. 吉林医学, 2017, 38(10): 1970-1972. doi: 10.3969/j.issn.1004-0412.2017.10.084
    [11]
    GOU B H, GUAN H M, BI Y X, et al. Gestational diabetes: weight gain during pregnancy and its relationship to pregnancy outcomes[J]. Chin Med J (Engl), 2019, 132(2): 154-160. doi: 10.1097/CM9.0000000000000036
    [12]
    MOORE SIMAS T A, WARING M E, CALLAGHAN K, et al. Weight gain in early pregnancy and risk of gestational diabetes mellitus among Latinas[J]. Diabetes Metab, 2019, 45(1): 26-31. doi: 10.1016/j.diabet.2017.10.006
    [13]
    牛杨, 李继, 盛金叶, 汤庆娅. 膳食营养干预对妊娠期糖尿病妊娠结局的作用[J]. 中华全科医学, 2017, 15(2): 295-297. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201702034.htm
    [14]
    裴玲俐. 妊娠中晚期营养指导对妊娠期糖尿病孕妇血糖控制和新生儿体重的影响[J]. 黑龙江医药, 2020, 33(1): 162-164. https://www.cnki.com.cn/Article/CJFDTOTAL-HJYY202001079.htm
    [15]
    叶健敏. 体重指数对妊娠期糖尿病孕妇血糖水平及营养摄入的影响[J]. 全科医学临床与教育, 2019, 17(8): 737-738, 741. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYL201908022.htm
    [16]
    张瑾. 分析营养治疗对妊娠期糖尿病患者体重增加与新生儿体重及血糖的影响[J]. 中国保健营养, 2019, 29(33): 313. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX201924027.htm
    [17]
    欧月英. 营养干预、健康宣教对妊娠糖尿病血糖、体重控制效果的研究[J]. 吉林医学, 2017, 38(12): 2372-2373. doi: 10.3969/j.issn.1004-0412.2017.12.082
    [18]
    CARROLL DANA, KELLEY KRISTI W, 许岭翎. 在需要药物治疗的妊娠糖尿病妇女中, 格列本脲可能优于胰岛素和二甲双胍: 二甲双胍(需要时加胰岛素)的表现优于胰岛素[J]. 英国医学杂志中文版, 2016, 19(1): 52-54.
    [19]
    BADON S E, MILLER R S, QIU C, et al. Maternal healthy lifestyle during early pregnancy and offspring birthweight: differences by offspring sex[J]. J Matern Fetal Neonatal Med, 2018, 31(9): 1111-1117. doi: 10.1080/14767058.2017.1309383
    [20]
    王辉. 营养治疗对妊娠期糖尿病患者体重增加与新生儿体重及血糖的影响[J]. 中国保健营养, 2017, 27(6): 74. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX201924027.htm
    [21]
    杨桂莲, 龚灿辉, 陈霞, 等. 不同年龄妊娠合并糖尿病患者经营养治疗后妊娠结局的研究[J]. 实用预防医学, 2018, 25(3): 355-357. doi: 10.3969/j.issn.1006-3110.2018.03.030
    [22]
    COSSON E, BAZ B, GARY F, et al. Poor Reliability and poor adherence to self-monitoring of blood glucose are common in women with gestational diabetes mellitus and may be associated with poor pregnancy outcomes[J]. Diabetes Care, 2017, 40(9): 1181-1186. doi: 10.2337/dc17-0369
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(5)

    Article Metrics

    Article views (187) PDF downloads(2) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return