低碳水化合物飲食對妊娠糖尿病患者的影響

Effects of Low Carbohydrate Diet on Patients with Gestational Diabetes Mellitus

目的了解妊娠糖尿病(gestational diabetes mellitus GDM)患者攝取碳水化合物的範圍,探討低碳水化合物飲食治療對孕婦血糖控制,孕期體重增加及胎兒出生體重之影響。方法營饕師給予GDM患者個人化低碳水化合物飲食治療建議,由孕婦作血糖及飲食記錄。營養師在每次覆診時評估患者攝取的總熱量及碳水化合物量.體重及血糖監測記錄。結果接受醫學營餐治療(medical nutrition therapy MNT)的GDM患者有85%血糖控制良好,.攝取的碳水化合物是總熱量(34±3.72)%,孕婦孕期體重增加達I OM建議範圍,胎兒出生體重達WHO的建議水平,沒有低體重兒,巨大兒有1例。結論--個低於40%碳水化合物的均衡飲食,有利於孕婦控制血糖並讓母兒體重增長良好,是目前較適合妊娠糖尿病患者的飲食。

Objective To investigate the range of carbohydrate intake by gestational diabetes mellitus(GDM)patients and to explore the impacts of low carbohydrate medical nutrition therapy(MNT)on pregnant women’s glycemic control,maternal weight gain and fetal birth weight.Methods Dietitians provided individualized low carbohydrate MNT recommendations to GDM patients.Blood glucose levels and food records were made by pregnant women.In each follow up session,dietitians assessed patients’total calories and carbohydrate intake,weight and blood glucose level record.Results Eighty- ve percent of GDM patients who received MNT with(34%±3.72%)of total calories as carbohydrate has a good glycemic control.Pregnant women gained weight within the recommended range for pregnancy issued by IOM.Fetal birth weight met the recommendation issued by WHO.No low birth weight infant was found. ere was one case of fetal macrosomia found.Conclusion A balanced diet with less than 40%carbohydrate is bene cial to pregnant women's glycemic control and can optimize growth and development of the fetus.Hence,it should be recommended for pregnant women with Gestational Diabetes Mellitus.