低血糖生成指数膳食对妊娠期糖尿病患者糖脂代谢及母婴结局的影响

Effect of low glycemic index diet on glucose and lipid metabolism and maternal and infant outcomes in patients with gestational diabetes

目的探讨低血糖生成指数膳食干预对妊娠期糖尿病患者治疗效果及母婴结局的效果。方法采用前瞻性研究,选择泾阳县医院2016年10月至2018年10月收治的128例妊娠期糖尿病患者作为研究对象,采用随机数表法分为对照组和观察组各64例,对照组患者给予常规饮食干预,观察组在对照组基础上给予低血糖生成指数膳食干预,持续干预30 d。比较两组患者的干预效果、母婴结局及干预前后血糖指标、血脂指标及胰岛素抵抗指数的差异。结果干预后两组患者的空腹血糖、早餐后、午餐后、晚餐后2 h血糖明显低于干预前,且观察组患者干预后的上述指标明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的不良母婴结局发生率为3.13%,明显低于对照组的26.56%,差异有统计学意义(P<0.05);干预后,观察组和对照组患者的总胆固醇[(5.58±0.57) mmol/L vs (6.35±0.63) mmol/L]、甘油三酯[(4.16±0.82) mmol/L vs (5.25±0.25) mmol/L]、低密度脂蛋白[(2.43±0.46) mmol/L vs (2.88±0.77) mmol/L]、胰岛素抵抗指数(3.43±0.56 vs 4.21±0.78)比较,观察组明显低于对照组,但观察组患者的高密度脂蛋白为(2.72±0.86) mmol/L,明显高于对照组的(2.35±0.53) mmol/L,差异均有统计学意义(P<0.05)。结论低血糖生成指数膳食干预可以降低妊娠期糖尿病患者的血糖水平,改善母婴结局。

Objective To investigate the effect of dietary intervention with hypoglycemia index on the treatment of gestational diabetes mellitus and the outcome of maternal and infant. Methods A total of 128 cases of gestational diabetes patients, who admitted to Hospital of Jingyang County from October 2016 to October 2018, were selected and divided into the observation group and control group according to random number table method, with 64 cases in each group. The patients in the control group were given conventional diet intervention group, and the patients in the observation group were given low glycemic index diet intervention on the basis of the treatment of the control group.The intervention course was 30 d. The effects of intervention, maternal and infant outcomes, glucose, lipid and insulin resistance indexes before and after intervention were compared between the two groups. Results After intervention,fasting blood glucose, 2 h after breakfast, lunch and dinner in the two groups were all lower than before intervention,with statistically significant differences(all P<0.05), and the above indexes of the observation group were significantly lower than those of the control group(all P<0.05). The incidence of adverse maternal and infant outcomes in the observation group was 3.13%, which was significantly lower than 26.56% in the control group(P<0.05). After intervention, the total cholesterol, triglyceride, LDL, and insulin resistance index of the observation group were(5.58 ± 0.57) mmol/L,(4.16 ± 0.82) mmol/L,(2.43 ± 0.46) mmol/L, 3.43 ± 0.56, respectively, which were significantly lower than corresponding(6.35±0.63) mmol/L,(5.25±0.25) mmol/L,(2.88±0.77) mmol/L, 4.21±0.78 before intervention, but HDL in the observation group was(2.72±0.86) mmol/L, which was significantly higher than(2.35±0.53) mmol/L in the control group(all P<0.05). Conclusion Low glycemic index diet therapy can reduce the blood glucose level of patients with gestational diabetes mellitus and improve maternal and infant outcomes.