二甲双胍联合膳食纤维饮食干预对妊娠期糖尿病孕妇动态血糖、营养状况和妊娠结局的影响

Effects of Metformin Combined with Dietary Fiber Dietary Intervention on Dynamic Blood Glucose,Nutritional Status and Pregnancy Outcome in Pregnant Women with Gestational Diabetes Mellitus

目的 观察二甲双胍联合膳食纤维饮食干预对妊娠期糖尿病孕妇动态血糖、营养状况和妊娠结局的影响。方法 选取2020年4月-2022年5月浦城县总医院仙阳分院收治的88例妊娠期糖尿病孕妇进行研究。采用简单随机分组法分为对照组和观察组,每组44例。对照组孕妇在常规治疗基础上予以口服二甲双胍片,观察组在对照组基础上采用营养师根据孕妇个体化情况设计的膳食纤维饮食干预,均干预至妊娠结束。比较两组孕妇干预前后的动态血糖、营养状况以及妊娠结局的变化。结果 干预后,观察组糖化血红蛋白、空腹血糖、餐后2 h血糖水平均低于对照组,差异有统计学意义(P<0.05)。观察组的微型营养评价量表评分、血蛋白、转铁蛋白水平均高于对照组,差异有统计学意义(P<0.05)。观察组不良妊娠结局率为15.91%低于对照组的36.36%,差异有统计学意义(P<0.05)。结论 二甲双胍联合膳食纤维饮食干预对妊娠期糖尿病孕妇血糖指标改善、营养状况提升和妊娠结局有良好作用,且安全性较高。

Objective To observe the effects of metformin combined with dietary fiber dietary intervention on dynamic blood glucose,nutritional status and pregnancy outcome of pregnant women with gestational diabetes mellitus.Methods A total of 88 pregnant women with gestational diabetes mellitus admitted to Xianyang Branch of Pucheng County General Hospital from April 2020 to May 2022 were selected for study.They were divided into control group and observation group by simple random grouping method,44 cases in each group.Pregnant women in the control group were given oral metformin tablets on the basis of routine treatment,and the observation group was given dietary fiber diet intervention designed by nutritionists according to the individual situation of pregnant women on the basis of the control group,all of which were intervened until the end of pregnancy.The changes of dynamic blood glucose,nu-tritional status and pregnancy outcome before and after intervention were compared between the two groups.Results After intervention,the levels of glycosylated hemoglobin,fasting plasma glucose and 2-hour postprandial blood glu-cose in the observation group were lower than those in the control group,and the differences were statistically signifi-cant(P<0.05).The scores of Mini-Nutritional Assessment Scale,blood protein and transferrin levels in the observa-tion group were higher than those in the control group,and the differences were statistically significant(P<0.05).The adverse pregnancy outcome rate of the observation group was 15.91%,which was lower than that of the control group(36.36%),and the difference was statistically significant(P<0.05).Conclusion Metformin combined with dietary fiber dietary intervention has a good effect on the improvement of blood glucose index,nutritional status and pregnancy out-come of pregnant women with gestational diabetes mellitus,and it is safe.