Effect Of Medical Nutrition Therapy On Gestational Diabetes Mellitus

Research background and purposeDiabetes mellitus gestational(GDM)is one of the most common complications of pregnancy,which refers to the different degrees of abnormal glucose metabolism during pregnancy or the first time.The results of prospective study of more than 10 thousand pregnant women in 18 cities in China show that the incidence of GDM in China is 4.3%?5.1%,which is similar to that reported by the United States in 3%-5%.In recent years,there have been reports that can reach 1.0%?14%or even reach 15%?17%.Studies show that GDM pregnant women with fetal growth and development abnormalities,fetal malformations,abortion,premature birth,amniotic fluid is too much and so the probability of a significant increase of GDM on maternal and child health in the long term can cause great harm.GDM patients with postpartum 6-28 years,about 2.6%-70%will develop into type 2 diabetes.GDM pregnant women in the future will be more than 50%of the final diabetes and long-term complications,recurrence of pregnancy GDM up to 33%-56%.GDM children in the future suffer from impaired glucose tolerance,childhood obesity,mental disorders,such as increased risk of.The traditional health education is the main means of intervention of GDM,there is no denying that it has played a certain role in the treatment of GDM,but it has some disadvantages,which does not take into account the individual differences in GDM pregnant women,not according to different status of each pregnant women received individual health education,the effect is limited.And oral hypoglycemic drugs in the treatment of GDM there is a certain problem,that is,whether the use of pregnancy there is still some controversy.Although some foreign studies have confirmed that the control of GDM patients with pioglitazone and metformin is effective,safe,and there are also published articles related to.However,it is easy to cause hypoglycemia,metformin can be through the placenta,and there is still a lack of two drugs used in GDM patients after their long-term impact on the safety of the fetus to track the results of observation.So far,our country still lacks the experience of oral hypoglycemic drugs in pregnancy.Insulin is still the first choice for the current control of high blood glucose in pregnancy.However,studies have shown that patients with type 2 diabetes mellitus patients with insulin pen injection treatment adherence to a good proportion of 43.8%.The main factors that affect the compliance of patients:20%of the economic situation,the awareness of their own disease and prognosis accounted for 33%of the treatment effect of the degree of recognition accounted for 26%,self management capacity of 20%.And injection of insulin operation is more complicated,the use of experience is poor,patients do not want to use is also led to poor compliance with another reason.In this case,it is urgent to seek a new medical method for the treatment of GDM.MNT is a kind of medical nutrition therapy,the research object to calculate the required daily calories by 90 kcal equal food exchange method,and the three major nutrients productivity ratio analysis,expect to achieve individualized nutritional intervention for GDM,maternal pregnancy weight management,improve blood glucose control in patients with GDM and pregnancy outcome objective.MNT not only to ensure the supply of nutrients in pregnant women and fetuses,and to ensure the pregnancy weight control,to achieve and maintain normal blood glucose level,prevent complications,avoid the purpose of ketosis.MethodJanuary 2013-June 2015 in Jiaxing Maternal and Child Health-Care Center maternity clinic regularly check,data integrity,and delivered in our hospital GDM pregnant women as the research object,exclude people with serious heart,liver,kidney and lung disease,severe anemia,pre pregnancy diabetes and thyroid function complications.In 451 cases,233 cases were divided into two groups according to their wishes,and 228 cases in MNT group(control group)and cases in the control group were divided into two groups.Doctors inform the study of the purpose of the study and to reject the harm of MNT,the object of study informed consent.The observation group was given MNT nutritional intervention,the control group was given regular obstetric examination and pregnancy health education.Observation time for medical nutrition therapy began to before delivery.The follow-up value of blood glucose,high risk factors and pregnancy outcome were recorded,and the data were collected and analyzed.ResultComparison of two groups of pregnant women in age,pre pregnancy BMI,gestational age,parity and family history of GDM,the difference was not statistically significant(P>0.05),comparable.But in high risk pregnancy(67.71%),the rate of cesarean section(55.16%),(0.90%),preterm low birth weight infants(1.80%)and(9.42%)life and disease incidence were lower than the control group 76.75%,70.61%,9.65%and 11.84%(2=6.64,P<0.05).conclusionGDM pregnant women with reasonable medical nutrition therapy,to improve the pregnancy outcome and neonatal disease has a positive effect.