不同食物交换系统对妊娠期糖尿病患者的影响

发布时间：2018-03-09 23:39

本文选题：糖尿病　切入点：妊娠　出处：《中国糖尿病杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨基于血糖负荷(GL)或基于血糖生成指数(GI)及传统食物交换份法在GDM患者中的应用效果,为临床营养干预提供参考。方法将113例妊娠28周前GDM患者随机分为基于GI的食物交换份法(GI)组38例、基于GL的食物交换份法(GL)组43例及传统食物交换份法(Con)组32例。分别测量干预前与分娩后FPG、1 hPG、2 hPG、HbA_1c、TG、TC等指标,记录分娩时巨大儿发生率、胎儿宫内窘迫情况、新生儿低血糖发生率、剖宫产率。结果 GI组完成33例,GL组完成33例,Con组完成31例。干预后,各组1 hPG、2 hPG、HbA_1c、TG及TC均较干预前降低,且Con组高于其他两组(P0.05)。Con组巨大儿发生率(32.3%vs6.1%vs 12.1%)、胎儿宫内窘迫情况(12.9%vs 12.1%vs6.1%)、新生儿低血糖发生率(6.5%vs 0%vs 3.0%)、剖宫产率(45.2%vs 21.2%vs 33.3%)均高于其他两组,且GL组低于GI组(P0.05)。结论结合GI或GL的改良食物交换份法更有助于改善GDM患者糖脂代谢状况,并改善妊娠结局;其中,基于GL的改良食物交换份法效果更好。
[Abstract]:Objective to investigate the effect of glucose load GLI or Gi) and the traditional method of food exchange in patients with GDM. Methods 113 patients with GDM before 28 weeks gestation were randomly divided into GI based food exchange method and GI group. GL-based food exchange method (GLL) group (43 cases) and traditional food exchange method (Conn) group (32 cases) were measured before and after the intervention. The incidence of macrosomia, fetal distress and neonatal hypoglycemia were measured before and after the intervention, and the levels of HbA1cTGTC were recorded. Results the rate of cesarean section in GI group (33 cases), GL group (33 cases) and Con group (31 cases) were all decreased after intervention. The incidence of macrosomia in the Con group was higher than that in the other two groups (P 0.05. Con). The incidence of macrosomia in the Con group was 32. 3 and that in the intrauterine fetal distress group was 12. 9 vs 12. 1 vs 12. 1 vs 6. 1. The incidence of neonatal hypoglycemia was 6. 5 vs 0. 0 vs 3. 0. The cesarean section rate was higher than that in the other two groups. Conclusion the improved food exchange method combined with GI or GL can improve glucose and lipid metabolism and improve pregnancy outcome in patients with GDM, and the improved food exchange method based on GL is more effective.
【作者单位】：南通市妇幼保健院内科;南通市妇幼保健院妇产科;无锡市第三人民医院妇产科;
【基金】：江苏省营养学会营养与健康研究资助项目(JYX201303) 无锡市卫生局适宜卫生技术推广项目(T201308);无锡市卫生局妇幼保健项目(FYKY201402)
【分类号】：R714.256

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