低血糖负荷食物交换份法的营养治疗对妊娠糖尿病患者血糖、胰岛素使用率、体重增长及其妊娠结局的影响

The Effect of Nutritional Therapy of Low-glycemic Load Food Exchange Method on Blood Glucose,Insulin Usage,Weight Gain and Pregnancy Outcome in Patients with Gestational Diabetes

目的分析对妊娠糖尿病患者应用低血糖负荷食物交换份法营养治疗的临床价值及对其血糖、胰岛素使用率、体重增长、妊娠结局的影响。方法抽选于2019年1—12月期间该院共收治的妊娠糖尿病患者450例,根据就诊顺序划分组别,即对照组、研究组,每组225例。两组均进行营养治疗,其中对照组接受传统食物交换份法,研究组接受低血糖负荷食物交换份法。评价及对比两组血糖指标、胰岛素使用率、体重增长、妊娠结局。结果研究组的空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)水平均低于对照组,差异有统计学意义(P<0.05);相较于对照组,研究组的空腹胰岛素、胰岛素抵抗指数(HOMA-IR)、胰岛素使用率均明显下降,差异有统计学意义(P<0.05);研究组的BMI指数、孕周26~34周的体重增长低于对照组,差异有统计学意义(P<0.05);研究组的剖宫产、妊高症、新生儿窒息率均低于对照组,差异有统计学意义(χ^2=14.286、10.698、19.378,P<0.05)。结论对妊娠糖尿病患者应用低血糖负荷食物交换份法营养治疗,可有效控制血糖,改善胰岛素抵抗状态,同时还可合理控制孕期体重增长,有助于改善不良妊娠结局,确保母婴安全。

Objective To analyze the clinical value of low-glycemic load food exchange nutrition therapy in patients with gestational diabetes and its effect on blood sugar,insulin usage,weight gain and pregnancy outcome.Methods A total of 450 patients with gestational diabetes who were admitted to the hospital from January to December 2019 were selected and divided into groups according to the order of treatment,namely the control group and the study group,225 cases in each group.Both groups received nutritional therapy.The control group received the traditional food exchange method,and the study group received the low-glycemic load food exchange method.Evaluated and compared the blood glucose index,insulin usage rate,weight gain,pregnancy outcome of the two groups.Results The fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),and glycosylated hemoglobin(HbA1c)levels of the study group were lower than those of the control group,the difference was statistically significant(P<0.05);compared with the control group,the study group’s fasting insulin and insulin resistance Index(HOMA-IR)and insulin use rate were significantly decreased,the difference was statistically significant(P<0.05);the BMI index and weight gain of 26~34 weeks gestational week of the study group were lower than those of the control group,the difference was statistically significant(P<0.05);the rates of pregnancy-induced hypertension and neonatal asphyxia were lower than those of the control group,the difference was statistically significant(χ^2=14.286,10.698,19.378,P<0.05).Conclusion The application of low-glycemic load food-exchange nutrition therapy to patients with gestational diabetes can effectively control blood glucose and improve insulin resistance.At the same time,it can also reasonably control weight gain during pregnancy,which helps to improve adverse pregnancy outcomes and ensure mother and baby safety.