妊娠期糖尿病患者采用不同能量系数计算的每日能量供给对血糖管理及新生儿体重的影响

Effects of daily energy supply with different energy coefficients on blood glucose management and neonatal weight in patients with gestational diabetes mellitus

目的探讨妊娠期糖尿病患者采用不同能量系数计算的每日能量供给对血糖管理及新生儿体重的影响。方法480例妊娠期糖尿病患者,根据能量系数上下限值将患者分为观察1组(根据能量系数下限值计算提供能量供应)和观察2组(根据能量系数上限值计算提供能量供应),每组240例;另选取同期孕检妊娠期糖尿病患者100例作为对照组。观察组患者均给予糖尿病一日门诊体验套餐,观察1组患者根据能量系数下限值计算提供能量供应,观察2组患者根据能量系数上限值计算提供能量供应;对照组患者不参加糖尿病一日门诊体验套餐。对比观察1组和观察2组、观察组和对照组患者的血糖检测情况及新生儿体重。结果观察1组患者的血糖达标率显著高于观察2组,血糖超标率显著低于观察2组,差异有统计学意义(P<0.05);两组患者的空腹血糖和餐后2 h血糖比较差异均无统计学意义(P>0.05);观察1组新生儿体重(3325.78±316.25)g显著低于观察2组的(3715.82±472.36)g,差异具有统计学意义(P<0.05)。两组患者均未出现低血糖。观察组患者的低血糖率显著低于对照组,血糖达标率显著高于对照组,血糖超标率显著低于对照组,差异有统计学意义(P<0.05);观察组患者尿酮体阳性率、糖化血红蛋白、新生儿体重均显著低于对照组,差异具有统计学意义(P<0.05)。结论糖尿病一日门诊能控制妊娠期糖尿病的血糖指数,减小新生儿体重过重的几率;选取能量系数的下限值进行每日能量计算,既可以为孕妇提供充足的能量摄取,也可以合理监管孕妇的餐后血糖。

Objective To discuss the effects of daily energy supply with different energy coefficients on blood glucose management and neonatal weight in patients with gestational diabetes mellitus.Methods According to the upper and lower limit of energy coefficient,480 patients with gestational diabetes mellitus were divided into observation group 1(lower limit of energy coefficient)and observation group 2(upper limit of energy coefficient),with 240 cases in each group.Another 100 patients with gestational diabetes mellitus for production inspection were selected as the control group.The patients in the observation group were given a one-day outpatient experience package for diabetes mellitus.The patients in the observation group 1 were provided with energy supply according to the lower limit of energy coefficient,and the patients in the observation group 2 were provided with energy supply according to the upper limit of energy coefficient.The patients in the control group did not participate in the one-day outpatient experience package for diabetes mellitus.The blood glucose testing and neonatal weight between observation group 1 and 2,observation group and control group was compared.Results The blood glucose compliance rate of observation group 1 was significantly higher than that of observation group 2,and excessive blood glucose rate was significantly lower than that of observation group 2,and the difference was statistically significant(P<0.05).There was no statistically significant difference in fasting blood glucose and 2-h postprandial blood glucose between the two groups(P>0.05).Neonatal weight(3325.78±316.25)g of observation group 1 was significantly lower than that of observation group 2(3715.82±472.36)g,and the difference was statistically significant(P<0.05).There was no hypoglycemia in both groups.The hypoglycemia rate of the observation group was significantly lower than that of the control group,blood glucose compliance rate was significantly higher than that of the control group,and excessive blood glucose rate was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The urine ketone body positive rate,glycated hemoglobin,neonatal weight of the observation group was significantly lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The one-day outpatient experience package can control the glycemic index of gestational diabetes and reduce the chance of overweight of the newborn.Lower limit of the energy coefficient for daily energy calculation can provide sufficient energy intake for pregnant women and can also be reasonably supervise the postprandial blood glucose of pregnant women.