摘要
目的:探索不同的主食选择对妊娠期糖尿病(GDM)患者血糖的影响。方法:本研究根据主食不同分为两组,招募2018年5至8月22~40岁孕24~28周自愿参加本研究的GDM患者20例并编号,采用抽签的方法进行完全随机化分组。合并严重的内外科疾病,既往有糖代谢异常、抽烟、多胎妊娠,或依从性较差的孕妇将排除。对照组患者予以杂面薯类主食,干预组予以杂粮饭主食,干预4周后,两组间总能量、宏量营养素供能比、餐食的能量分配相同。采用连续血糖监测系统(CGMS)进行血糖监测,并计算午餐、晚餐后升高血糖曲线下面积(IAUC)。结果:共17例GDM孕妇完成本研究,包括8例对照组,9例干预组。经过膳食干预后,两组孕妇血糖达标率分别为(89.20±6.06)%比(90.61±5.25)%,糖化白蛋白(GA)分别为(12.46±0.84)%比(12.46±0.84)%,两组无显著差异(P>0.05);剖宫产率、母婴围产期并发症的发生率等在两组间比较差异也无统计学意义。干预组较对照组午餐[(111.0±78.9)比(137.3±84.4)]、晚餐[(111.0±74.8)比(137.0±87.7)]餐后2 h IAUC低,差异有统计学意义,显示干预组具有更好的餐后血糖稳定性。结论:本研究采用的膳食干预方案具备较好的GDM管理效果,且杂粮饭较杂面薯类主食有着更佳的GDM餐后血糖水平。
Objective This study aimed to investigate the influence of staple food type on glucose levels in women with gestational diabetes mellitus(GDM).Methods The drawing lots method was used for randomized grouping.The subject inclusion criteria were being a pregnant woman and diagnosed with GDM at 24-28 weeks gestation.Anyone with severe internal or external disease,previous abnormal glucose metabolism,smoking history,multiple pregnancies,or poor compliance was excluded.Twenty pregnant women were enrolled and were randomized to receive meals and snacks consisting of wholegrain flour products and tuber vegetables(control group)or wholegrain rice(intervention group)for 4 weeks.In the administration of the meals,energy supply,energy distribution,and nutrient level were matched between the two groups.A continuous glucose monitoring system was used for monitoring glucose level,and postprandial glycemia(incremental area under the curve)was measured after lunch and dinner.Results A total of 17 women with GDM completed the study(8 in group A and 9 in group B).After the dietary intervention,the compliance rate of blood glucose in groups A and B was(89.20±6.06)%and(90.61±5.25)%,and glycated albumin was(12.46±0.84)%and(12.46±0.84)%,respectively(P>0.05).Moreover,there were no significant differences in cesarean section rate or perinatal complications between the two groups.The incremental area under the curve of glucose within 2 hours after lunch[(137.3±84.4)vs(111.0±78.9)]and dinner[(137.0±87.7)vs(111.0±74.8)]were both significantly lower in the intervention group compared with the control group,which indicates a more stable postprandial glucose response to GDM with wholegrain rice.Conclusion The intervention diet used in this study showed good glucose control for GDM pregnancies;a diet with wholegrain rice as the staple food led to more stable postprandial glucose response than a diet with wholegrain flour products and tuber vegetables as the staple food.
作者
王方
刘燕萍
包媛媛
李珊珊
马良坤
Wang Fang;Liu Yanping;Bao Yuanyuan;Li Shanshan;Ma Liangkun(Department of Clinical Nutrition,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)
出处
《中华健康管理学杂志》
CAS
CSCD
2021年第4期332-337,共6页
Chinese Journal of Health Management
基金
北京市科技计划项目(Z161100000516117)。
关键词
糖尿病
妊娠
营养疗法
血糖
Diabetes,gestational
Nutrition therapy
Blood glucose
