医学营养联合运动训练干预妊娠期糖尿病患者对妊娠结局的影响

Effect of medical nutrition combined with exercise training on pregnancy outcome in patients with gestational diabetes mellitus

目的探讨医学营养联合运动训练干预妊娠期糖尿病患者对妊娠结局的影响。方法 100例妊娠期糖尿病患者,随机分为实验组和对照组,每组50例。实验组患者给予医学营养联合运动训练进行干预,对照组患者给予常规方法进行干预。对比两组患者干预前后空腹血糖(FPG)、口服葡萄糖耐量试验(OGTT)1 h血糖、2 h血糖、空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)水平及不良妊娠结局发生情况。结果干预后,实验组患者FPG、OGTT 1 h血糖水平以及OGTT 2 h血糖水平分别为(4.33±0.48)、(8.86±0.62)、(7.16±0.62)mmol/L,均显著低于对照组的(5.01±0.61)、(9.27±0.79)、(8.12±0.58)mmol/L,差异具有统计学意义(P<0.05)。干预后,实验组FINS、HOMA-IR水平低于对照组, HOMA-β水平高于对照组,差异具有统计学意义(P<0.05)。实验组患者不良妊娠结局发生率为6.00%(3/50),显著低于对照组的36.00%(18/50),差异具有统计学意义(P<0.05)。结论针对妊娠期糖尿病患者,通过给予医学营养联合运动训练干预可以显著改善患者胰岛素分泌情况以及血糖水平,对于降低不良妊娠结局发生率、确保母婴安全意义重大。

Objective To discuss the effect of medical nutrition combined with exercise training on pregnancy outcome in patients with gestational diabetes mellitus. Methods A total of 100 patients with gestational diabetes mellitus were randomly divided into experimental group and control group, with 50 cases in each group. The experimental group received medical nutrition combined with exercise training for intervention, and the control group received conventional method for intervention. The fasting plasma glucose(FPG), oral glucose tolerance test(OGTT) 1 h blood glucose, 2 h blood glucose, fasting insulin(FINS), homeostasis model assessment-β(HOMA-β), homeostasis model assessment-insulin resistance(HOMA-IR) levels before and after intervention and occurrence of adverse pregnancy outcomes were compared between the two groups. Results After intervention, the levels of blood glucose level of FPG, OGTT 1 h and OGTT 2 h were(4.33±0.48),(8.86±0.62) and(7.16±0.62) mmol/L respectively in the experimental group, which were significantly lower than(5.01±0.61),(9.27±0.79) and(8.12±0.58) mmol/L in the control group, and their difference was statistically significant(P<0.05). After intervention, the FINS and HOMA-IR level in the experimental group was lower than those in the control group, and HOMA-β level was higher than that in the control group. Their difference was statistically significant(P<0.05). The incidence of adverse pregnancy outcome was 6.00%(3/50) in the experimental group, which was significantly lower than 36.00%(18/50) in the control group, and the difference was statistically significant(P<0.05). Conclusion For gestational diabetes mellitus patients, the combination of medical nutrition and exercise training can significantly improve the insulin secretion and blood glucose level, which is of great significance to reduce the incidence of adverse pregnancy outcomes and ensure the safety of mothers and infants.