低血糖生成指数膳食干预在妊娠期糖尿病患者血糖控制及妊娠结局的影响

Effects of Low Glycemic Index Dietary Intervention on Glycemic Control and Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus

目的 探究低血糖生成指数(low glycemic indsx,LGI)膳食干预应用于妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖控制及妊娠结局的临床效果。方法 选择厦门大学附属成功医院2019年1月—2021年6月收治的366例GDM患者,用随机数表法分为对照组(给予常规饮食干预)、观察组(给予LGI膳食干预),每组183例。持续干预直至分娩,比较两组干预效果。结果 干预后,观察组早餐前空腹血糖(FPG)、早餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)均低于对照组,差异有统计学意义(P<0.05);干预后,观察组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)均低于对照组,高密度脂蛋白胆固醇(HDL-C)高于对照组,差异有统计学意义(P<0.05);干预后,观察组胰岛素抵抗指数低于对照组,凝血酶原时间(PT)高于对照组,纤维蛋白原(FIB)、D-二聚体差异(D-D)均低于对照组,差异有统计学意义(P<0.05);观察组产后出血、羊水过多、宫缩乏力、胎儿早产、胎儿窒息发生率均低于对照组,差异有统计学意义(P<0.05)。结论LGI膳食干预可提高GDM患者血糖控制效果,并改善凝血功能和妊娠结局。

Objective To explore the clinical effect of low glycemic index(LGI) dietary intervention on glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods 366 GDM patients admitted to Xiamen University Affiliated Chenggong Hospital from January 2019 to June 2021 were selected.They were divided into control group(given routine dietary intervention) and observation group(given LGI dietary intervention) by random number table method,with 183 cases in each group.The intervention continued until delivery.The effects of the two interventions were compared.Results After the intervention,the fasting blood glucose(FPG) before breakfast,2 h blood glucose(2 hPG) after breakfast,and glycosylated hemoglobin(HbA1c) in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).After intervention,the total cholesterol(TC),triglyceride(TG) and low-density lipoprotein cholesterol(LDL-C) in the observation group were lower than those in the control group,high-density lipoprotein cholesterol(HDL-C) was higher than the control group,the difference was statistically significant(P<0.05).After the intervention,the insulin resistance index of the observation group was lower than that of the control group,the prothrombin time(PT) in the observation group was higher than that in the control group,and the difference in fibrinogen(FIB) and D-dimer(D-D) in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).The incidence rates of postpartum hemorrhage,polyhydramnios,uterine atony,fetal premature birth and fetal asphyxia in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion LGI dietary intervention can improve glycemic control,coagulation function and pregnancy outcomes in patients with GDM.