专用营养配方粉对妊娠期糖尿病患者血糖及妊娠结局的影响

Effects of a nutritional liquid supplement designed for diabetes mellitus on postprandial glucose and pregnancy outcomes in patients with gestational diabetes mellitus

目的 探讨加用糖尿病专用营养配方粉对妊娠期糖尿病（GDM）患者餐后血糖及妊娠结局的影响.方法 将2011年10月至2012年1月在重庆医科大学附属第一医院进行产前检查的69例GDM孕妇随机分组,完成研究的干预组31例,对照组29例.对60例GDM孕妇干预前的临床资料、干预后餐后2 h指尖血糖值及围产结局进行分析;用一般线性模型的Repeated Measures过程实现餐后2 h血糖资料的方差分析,通过球形检验的结果判断相关性.结果 （1）两组对象干预前临床资料比较差异无统计学意义（P〉0.05）.（2）干预后餐后2 h血糖水平（mmol/L）为：干预组：6.2±0.7（1周）、5.9±0.5（2周）、5.7±0.5（3周）、5.8±0.6 （4周）、5.7±0.5（5周）、5.7±0.4（6周）、5.9±0.3 （7周）、6.0±0.4（8周）及6.0±0.5（9周）;对照组：6.7±0.3 （1周）、6.2±0.4（2周）、6.2±0.5（3周）、6.2±0.4（4周）、6.1±0.4（5周）、6.0±0.3 （6周）、5.8±0.4（7周）、6.1±0.4（8周）及6.1±0.4（9周）.干预组餐后血糖水平显著低于对照组（P〈0.01）.（3）干预组孕妇胎膜早破、羊水过多患病率,孕妇分娩时体重、糖化血红蛋白值,新生儿出生体重以及新生儿肺炎患病率均显著低于对照组（P〈0.05）.结论 与应用普通膳食相比,妊娠期糖尿病患者加用糖尿病专用营养配方粉能够显著降低餐后血糖、改善母儿预后.

Objective To explore the effects of nutritional liquid supplement designed for diabetes mellitus on postprandial glucose state and pregnancy outcomes in patients with gestational diabetes me]litus （GDM）. Methods A total of 69 cases of pregnant GDM women at Department of Obstetrics dr Gynecology, First Affiliated Hospital, Chongqing Medical University from October 2011 to January 2012 were randomized into the intervention and control groups. But only 31 cases in intervention group finished the study versus 29 cases in control group. The inter-group differences were analyzed for general clinical profiles before intervention, 2-hour postprandial blood glucose levels and pregnancy outcomes, etc. The General Linear Model Repeated Measures process was used to analyze the variance of 2-hour postprandial blood glucose data. And the Mauchy＇s test of sphericity was employed to determine the correlation. Results （ 1 ） No significant difference in general clinieal profiles before intervention between intervention and control groups （ P 〉 0. 05 ）. （2） The mean values of 2-hour postprandial blood glucose were as follows ： intervention group （mmol/L） ： 6.2±0.7（lw）, 5.9 ±0.5（2w）, 5.7 ±0.5（3w）, 5.8-±0.6 （4w）, 5.7±0. 5（5w）, 5.7± 0. 4（6w）, 5.9 ±0. 3（7w）, 6. 0 ±0. 4（8w）, 6. 0 ±0. 5（9w） ; control group： 6. 7 ±0. 3 （ lw）, 6. 2 ±0. 4 （2w）, 6.2±0.5（3w）, 6.2±0.4（4w）,6.1±0.4（Sw）, 6.0±0.3 （6w）, 5.8 ±0.4 （7w）, 6.1 ±0.4 （8w）, 6. 1 ±0. 4（9w）. The results of Mauchy＇s test of sphericity indicated that the blood glucose level of the intervention group was significantly lower than that of the control group （ P 〈 0. 01 ）. （ 3 ） The incidence of premature rupture of membranes and polyhydramnios, rate of neonatal pneumonia, weight of newborn and pregnancy women and level of glycosylated hemoglobin in intervention group were significantly lower than those in control group （ P 〈 0.05 ）. Conclusion Compared with common diet, after using nutritional supplement, the postprandial blood glucose level is improved in GDM patients.