胰岛素结合个体化医学营养治疗对妊娠期糖尿病患者血糖控制、膳食结果及母婴结局的影响

Effect of Insulin Combined with Individualized Medical Nutrition Therapy on Glycemic Control,Dietary Outcomes and Maternal and Infant Outcomes in Patients with Gestational Diabetes Mellitus

目的探讨胰岛素结合个体化医学营养治疗对妊娠期糖尿病患者血糖控制、膳食结果及母婴结局的影响。方法选取2020年1月—2022年1月江华县人民医院产科收治的80例妊娠期糖尿病患者,按区组随机化法分为两组,即对照组40例,采用胰岛素治疗;观察组40例,在此基础上采用个体化医学营养治疗。对比两组患者孕期血糖控制效果、体质量情况、膳食结构以及母婴结局。结果观察组治疗4周、12周时的血糖水平低于对照组,治疗2周、4周、8周时的体质量增长值低于对照组,差异有统计学意义(P<0.05)。观察组治疗后每日谷薯类食物摄入量低于对照组,绿色蔬菜高于对照组,禽肉类、鱼虾类高于对照组,畜肉类低于对照组,豆制品高于对照组,油脂类低于对照组,差异有统计学意义(P<0.05)。观察组剖宫产率为15.00%低于对照组的40.00%,巨大儿、早产儿发生率低于对照组,差异有统计学意义(P<0.05)。结论胰岛素结合个体化医学营养治疗可提高妊娠期糖尿病孕妇孕期血糖控制效果,改善母婴结局,改变患者不良膳食结构。

Objective To investigate the effects of insulin combined with individualized medical nutrition therapy on glycemic control,dietary outcomes and maternal and infant outcomes in patients with gestational diabetes mellitus.Methods Eighty cases of gestational diabetes mellitus patients admitted to the Department of Obstetrics,Jianghua Yao Autonomous County People's Hospital from January 2020 to January 2022 were selected and divided into two groups according to the district group randomization method,namely,40 cases in the control group,which were treated with insulin;in the observation group,40 cases were treated with individualized medical nutrition therapy on top of that.The effect of glycemic control,weight,dietary structure and maternal and infant outcomes during pregnancy were compared between the two groups.Results The blood glucose level of the observation group at 4 and 12 weeks of treatment was lower than that of the control group,and the weight gain value at 2,4 and 8 weeks of treatment was lower than that of the control group,and the difference was statistically significant(P<0.05).The daily intake of cereals and potatoes in the observation group after treatment was lower than that in the control group,green vegetables were higher than that in the control group,poultry and fish and shrimp were higher than that in the control group,animal meat was lower than that in the control group,soy products were higher than that in the control group,and fats and oils were lower than that in the control group,and the difference was statistically significant(P<0.05).The cesar ean delivery rate of 15.00%in the observation group was lower than that of 40.00%in the control group,and the incidence of huge and preterm babies were lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Insulin combined with individualized medical nutrition therapy can improve glycemic control during pregnancy in pregnant women with gestational diabetes,improve maternal and infant outcomes,and change the poor dietary structure of patients.