高纤复合膳食纤维在妊娠期糖尿病医学营养治疗中的作用

Role of high fiber complex dietary fiber in medical nutrition therapy of GDM

目的通过评估高纤复合膳食纤维在妊娠期糖尿病(GDM)医学营养治疗中的作用,了解高纤复合膳食纤维的临床安全性。方法选取2019年1月至2020年1月上海三家医院120例GDM患者进行开放性随机对照临床观察。研究组采用MTN标准餐+高纤复合膳食纤维粉干预,对照组采用MTN标准餐调节饮食。比较研究组和对照组的人口统计学及基线疾病特征。结果高纤复合膳食纤维粉干预后,GDM患者的空腹血糖(FBG)、餐后2h血糖、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、孕妇孕期体重增长(GWG)、新生儿体重、肌酐(SCr)、谷丙转氨酶(ALT)以及谷草转氨酶(AST)低于对照组,高密度脂蛋白(HDL)高于对照组。高纤复合膳食纤维粉干预可使孕妇饱腹感比例大于80%,孕妇粪便4型、5型占比最多。结论GDM患者孕期使用高纤复合膳食纤维粉有利于血糖控制、血脂控制、体重控制及妊娠结局(新生儿体重)。高纤复合膳食纤维粉在孕期应用是安全的,可增强饱腹感,改善粪便性状。

Objective:To understand the clinical safety of high-fiber complex dietary fiber(HFCF)in gestational diabetes mellitus(GDM)by evaluating the role of high-fiber complex dietary fiber in medical nutrition treatment.Methods:A total of 120 GDM patients from three hospitals in Shanghai from January 2019 to January 2020 were selected for an open randomized controlled clinical observation.The study group was treated with MTN standard diet+high-fiber compound dietary fiber powder,and the control group was treated with MTN standard diet.Demographic and baseline disease characteristics were compared between study and control groups.Results:After intervention with high-fiber complex dietary fiber powder,fasting blood glucose(FBG),2h postprandial blood glucose,glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),gestational weight gain(GWG),neonatal weight,creatinine(SCr),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in GDM patients were higher than those in the control group.The high density lipoprotein(HDL)of the group was lower than that of the control group.High-fiber compound dietary fiber powder intervention can make the proportion of pregnant women satiety more than 80%,feces type 4 and 5 accounted for the most.Conclusions:The use of HFCF during pregnancy in GDM patients is beneficial to blood glucose control,blood lipid control,weight control and pregnancy outcome(neonatal weight).High fiber compound dietary fiber powder is safe in pregnancy,can enhance the sense of satiety of pregnant women,improve the fecal characteristics of pregnant women.