个体化饮食治疗提高妊娠糖尿病患者自我效能的应用研究

Application of individualized dietary therapy in improving self-efficacy in patients with gestational diabetes mellitus

目的探讨个体化饮食治疗对妊娠糖尿病(GDM)患者自我效能的影响。方法将四川省绵阳市第三人民医院确诊的100例GDM患者,根据就诊顺序分为观察组和对照组,对照组进行GDM常规饮食管理8周;观察组根据患者年龄、体重指数、孕周、血糖水平、营养状况及饮食习惯给予个体化的饮食治疗8周。对比分析两组患者治疗前后血糖控制情况及自我效能水平。结果治疗后观察组Hb A1c、FPG、餐后2 h血糖(2 h-PPG)水平低于对照组患者[(6. 34±1. 25)%vs (7. 04±1. 74)%、(5. 14±1. 76) mmol/L vs (6. 43±2. 11) mmol/L、(6. 31±1. 59) mmol/L vs (7. 32±2. 69)mmol/L],差异有统计学意义(P <0. 05)。治疗后,观察组患者自我效能评分[(33. 68±4. 12)分]显著高于治疗前[(21. 53±3. 45)分](P <0. 05),且高于对照组[(24. 87±5. 39)分],差异有统计学意义(P <0. 05)。而对照组患者自我效能评分较干预前无明显变化(P> 0. 05)。结论个体化饮食治疗可改善GDM患者血糖控制,提高患者自我效能。

Objective To explore the effect of individualized diet therapy on self-efficacy of gestational diabetes mellitus (GDM) patients. Methods A total of 100 cases of GDM patients diagnosed in our hospital were randomly divided into intervention group and control group according to the registration order. The control group was given routine GDM diet management for 8 weeks, and the intervention group was given individualized dietary therapy for 8 weeks according to the age, body mass index, gestational weeks, blood glucose levels, nutritional status and dietary habits. The levels of blood glucose and self-efficacy in the two groups of patients were compared before and after treatment. Results After treatment, the serum levels of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2 h-postprandial plasma glucose (2 h-PPG) in the intervention groups were significantly lower than those in the control group [(6.34±1.25)% vs (7.04±1.74)%,(5.14±1.76)mmol/L vs (6.43±2.11)mmol/L,(6.31±1.59)mmol/L vs (7.32±2.69)mmol/L, P<0.05]. And after treatment, the self-efficacy score of the intervention group was [(33.68±4.12)point], significantly higher than that of before treatment [(21.53±3.45)point](P<0. 05), and it was significantly higher than that of control group [(24.87±5.39)point]. But there was no significant difference in the control group before and after treatment (P>0.05). Conclusions Individualized dietary therapy can improve glycemic control and self-efficacy in patients with GDM.