高纤复合膳食纤维摄入对妊娠糖尿病患者血糖控制及妊娠结局的影响

Interventional effect of dietary fiber on blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus

目的:探讨高纤复合膳食纤维对妊娠糖尿病(GDM)患者血糖控制及妊期GDM患者为研究对象,随机分为膳食纤维组(n=56)和对照组(n=56),两组患者均接受基础营养治疗方案,膳食纤维组在此基础上添加膳食纤维方案(9.5g膳食纤维/d,餐前服用),共干预8周。每周检测空腹血糖、餐后2h末梢血糖(2hBG),产后42 d进行口服葡萄糖耐量试验(OGTT),并记录围产结局。结果:干预8周内膳食(P<0.05或P<0.01);产后OGTT服糖后2 h血糖值及糖耐量减低率低于对照组,低于对照组(P<0.05或P<0.01)。结论:高纤复合膳食纤维干预可有效控制GDM患者孕期血糖水平,改善围产期不良妊娠结局,减少产后糖耐量减低发生率。

Objective:To investigate the effect of dietary fiber on blood glucose andpregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods:Onehundred and twelve patients with GDM in the second trimester of pregnancy wererecruited from Women’s Hospital,Zhejiang University School of Medicine.Patients wererandomized into two groups with 56 in each group:the control group received basicnutrition support;while the dietary fiber group were given additional dietary fiber(9.5 gtotal dietary fiber per day)before meals in addition to basic nutrition support.Interventionfor all cases lasted for 8 weeks.Fasting blood glucose and 2 h postprandial blood glucose(2 h BG)were measured every week,and oral glucose tolerance test(OGTT)was performedat 42 d postpartum to evaluate the glycemic outcomes.Perinatal outcomes were recorded.Results:The dietary fiber intervention markedly improved 2 h BG in patients with GDMand significantly elevated the glucose compliance rate from the 3 rd to 8 th week comparedto the control group(P<0.05 orP<0.01).OGTT 2 h glucose and the incidence of impairedglucose tolerance in the dietary fiber group were significantly lower than those in thecontrol group,while the glucose compliance rate was significantly higher than that in thecontrol group(allP<0.01).Moreover,the rates of adverse perinatal outcomes,such aspremature rupture of membranes and neonatal hyperbilirubinemia were declined in thedietary fiber group(P<0.05 orP<0.01).Conclusion:Dietary fiber intervention canameliorate hyperglycemia in GDM patients,improve perinatal outcomes and reduce theincidence of postpartum impaired glucose tolerance.