高龄妊娠期糖尿病患者个体化医学营养疗效观察

Observation of curative effect of individualized medical nutrition therapy for advanced gestational diabetes mellitus

目的探讨个体化医学营养方案对高龄妊娠期糖尿病患者(advanced gestational diabetes mellitus,AGDM)血糖水平及妊娠结局的影响。方法选取2017年1月至2017年12月我院收治的AGDM患者100例,随机分为医学常规饮食指导组(medical routine diet guidance,MRDG组)和个体化医学营养方案治疗组(individualized medical nutrition therapy,IMNT组),每组各50例,分别给予常规饮食指导和个体化医学营养方案治疗,比较两组患者治疗后4周、8周和16周的血糖水平变化,观察两组患者胰岛素使用率及妊娠结局。结果 IMNT组血糖水平及胰岛素使用率明显低于MRDG组,妊娠不良结局的发生率亦明显低于MRDG组,差异均有统计学意义(P<0.05)。结论个体化医学营养方案对维持AGDM患者血糖水平稳定具有重要的作用,可明显减少妊娠期间胰岛素的使用,降低妊娠不良结局的发生,值得临床应用推广。

Objective: To investigate the effect of individualized medical nutrition therapy on blood glucose level and pregnancy outcome in AGDM.Methods: 100 GDM patients from January 2017 to September 2017 in our hospital were randomly assigned into conventional medicine group (Medical routine diet guidance,MRDG group) and individualized medical nutrition therapy group (Individualized medical,nutrition therapy,IMNT group),with 50 GDM patients in each group.The 2 groups of GDM patients were followed up and blood glucose levels were tracking.The changes of blood glucose level of 2 groups in 4 weeks,8 weeks and 16 weeks were compared,and the blood glucose level,the use rates of insulin and the pregnancy outcome of the 2 groups of GDM patients were observed.Results: The blood glucose level and the use rates of insulin of IMNT group after the intervention in patients were lower than those in group MRDG;The incidence of adverse pregnancy outcomes of IMNT group after the intervention in patients was lower than that in group MRDG,and the difference between the groups was statistically significant (P <0.05).Conclusion: Personalized medical nutrition plays an important role in maintaining the stability of blood glucose level in GDM patients.It can significantly reduce the use of insulin during pregnancy and reduce the incidence of adverse pregnancy outcomes,which is worthy of clinical application and promotion.