妊娠合并糖尿病的个体化医学营养治疗

Individualized Medical Nutrition Therapy for Pregnancy with Diabetes

目的探讨个体化医学营养治疗(MNT)对妊娠合并糖尿病孕妇的治疗效果及相关代谢指标的影响。方法方便选取2018年11月—2019年4月在该院治疗的32例妊娠合并糖尿病孕妇,根据治疗方法的不同将其分为常规保健组和个体化干预组,各16例。给常规保健组孕妇给予常规的饮食指导治疗,给个体化干预组孕妇给予个体化医学营养治疗,观察并比较两组孕妇在治疗前后血糖水平、相关代谢指标的变化情况以及不良妊娠结局的发生率。结果两组孕妇治疗前的血糖水平差异无统计学意义(P>0.05),经过治疗后,两组孕妇的FPG、OGTT-1 hPG、OGTT-2 hPG、TG水平均明显下降,并且个体化干预组下降的幅度大于常规保健组,差异有统计学意义(P<0.05),但是两组TC、HDL-C、LDL-C水平无显著变化,差异无统计学意义(P>0.05);个体化干预组不良妊娠结局的发生率(6.25%)低于常规保健组(50.00%),差异有统计学意义(P<0.05)。结论个体化医学营养治疗能够有效改善妊娠合并糖尿病孕妇体内糖代谢紊乱,并且对孕期增重、妊娠结局、血脂指标有明显的影响。

Objective To investigate the effect of individualized medical nutrition therapy(MNT)on the treatment effect and related metabolic indicators in pregnant women with diabetes mellitus.Methods A total of 32 pregnant women with diabetes mellitus who were convenient treated in the hospital from November 2018 to April 2019 were enrolled.According to different treatment methods,they were divided into 10 cases of routine health care group and individualized intervention group.Regular diet guidance treatment was given to pregnant women in the routine health care group,and individualized medical nutrition treatment was given to the pregnant women in the individualized intervention group.The changes of blood glucose levels,related metabolic indicators and the incidence of adverse pregnancy outcomes were observed and compared between the two groups.Results There was no significant difference in blood glucose levels between the two groups before treatment(P>0.05).After treatment,the FPG,OGTT-1 hPG,OGTT-2 hPG,TG levels of the two groups of pregnant women decreased significantly,and the extent of individualized intervention group decreased.Compared with the conventional health care group,the difference was significant(P<0.05),but there was no significant change in the levels of TC,HDL-C and LDL-C in the two groups(P>0.05).The incidence of adverse pregnancy outcomes in the individualized intervention group(6.25%)was lower than the conventional health care group(50.00%),and the difference was statistically significant(P<0.05).Conclusion Individualized medical nutrition therapy can effectively improve the glucose metabolism disorder in pregnant women with diabetes,and has obvious effects on pregnancy weight gain,pregnancy outcome and blood lipid index.