妊娠期糖尿病的生活方式干预管理

Management of life behavior for gestational diabetes mellitus

目的对妊娠期糖尿病(gestational diabetes mellitus,GDM0)患者进行生活方式干预,观察其对血糖的影响,和围产期并发症的改善情况。方法选择GDM患者65例,随机分为观察组(n=33)和对照组(n=32)。对观察组患者进行个体化膳食管理和运动规划,利用摄食记录表和运动手环进行每日记录。分析两组患者的血糖情况及围产期并发症的改善情况。结果经过1周生活方式干预,观察组患者空腹血糖及餐后2 h血糖较初始值明显降低,与初始血糖相比差异有统计学意义(P<0.05);2周后观察组与对照组比较,空腹血糖、餐后2 h血糖及糖化血清白蛋白差异有统计学意义(P<0.05);分娩前,观察组空腹血糖和餐后2 h血糖明显低于对照组,差异有统计学意义(P<0.05);观察组围产期并发症的发生率与对照组之间存在统计学差异(P<0.05),而与正常健康孕妇之间差异无统计学意义(P>0.05)。结论生活方式干预可有效地控制妊娠糖尿病患者的血糖水平,降低围产期并发症的发生率,改善妊娠结局。

Objective To assess the effect of behavioral intervention for patients with gestational diabetes mellitus （GDM）. Methods Sixty five patients with GDM were randomly assigned to intervention group （ n = 33 ） and control group （ n = 32 ）. Patients in intervention group received individual dietary guidance and exercise program; the daily diet was documented and the exercise was recorded with a sports bracelet. The blood glucose and pregnancy outcomes were analyzed in two groups. Results After a week of intervention, fasting glucose and 2 h postprandial blood glucose in intervention group were significantly lower than the initial values （P 〈 0. 05 ）. After 2 week intervention, the fasting glucose, 2 h postprandial blood glucose and glycated albumin in intervention group were significantly lower than those in control group （ P 〈 0.05 ）, and the difference between two groups continued until delivery （P 〈 0.05 ）. The incidence of perinatal complications was significantly lower in intervention group than that in control group （ P 〈 0. 05 ）. Conclusion The behavioral intervention can effectively improve the blood glucose level and reduce the incidence of pregnant and perinatal complications of patients with GDM.