| Aims:Based on the analysis of daily dietary features and habits of patients suffering from gestational diabetes mellitus(GDM),the nutritional diet standard is developed in a rational and scientific way,and the effect of the individual nutritional diet guidance on blood glucose control and pregnancy outcome of patients with gestational diabetes is observed.Methods:1.108 women of GDM received from May,2014 to February,2016 by the hospital are analyzed retrospectively and included into a GDM group while 50 healthy pregnant women received during the same period by the same hospital formed healthy control group.Through the food frequency method and the 24-hour meal survey method,to understand dietary habits and nutritional intake structure of all the pregnant women in two groups.Then related factors which may affect the onset of diabetes within the pregnancy cycle were explored.2.108 pregnant women with GDM were randomly divided into two groups including intervention group and control group,each group consisted of 54 patients.54 patients in intervention group were given professional and overall nutritional dietary guidance.The nutritional control management was strengthened till the delivery under a targeted nutrient intake scheme.Regular gestational diabetes nursing rather than nutritional dietary guidance was provided to54 patients in the control group.A comparison of glycemic index variance,insulin,weight improvement of pregnant women,deliver mode,newborn result and complication between two groups was made.Results:1.Dietary status and nutrients intake of pregnant women1)Dietary habits:the daily dietary of the GDM group contained25g or more cooking oil.The intake rates of beverage,refined sugar food and night snack in GDM women were higher than those of the health control pregnent women.Exercises after meals and the grease food intake rate were basically same in two groups.2)Dietary structure:GDM group of potatoes,vegetables,eggs,fish and shrimp,milk intake relative to the recommended intake was significantly insufficient,while livestock and poultry,soybeans and nuts intake is higher than the recommended intake.Fruit basically meet the recommended intake.The GDM women ate many more nuts,livestock meat,sweet potato&yams and fruits than the healthy control group did;On the contrary,the intake of deep-sea fish,poultry,coarse food and soya-bean milk was much lower.3)The intake of three major energy nutrients:Total dietary intakes of energy,protein and fat in GDM women are much more than those of the health control group;the ratio of energy provided by carbohydrate is lower than that of the health control group.4)Sources analysis of three energy nutrients:Carbohydrate:the dietary intake of carbohydrate from fruits and sweet potatoes in the GDM group was significantly higher than the healthy control group;the intake of carbohydrate from coarse food was much lower.Fat:Pregnant women of the GDM group ingested much more fat from livestock meat than those in the healthy control group did while the intake from fish fat was much less.Protein:Pregnant women with GDM ingested much more protein from livestock meat than those in the healthy control group did,but the intake from fish,poultry and beans was much less.2.Clinical effects of nutritional dietary guidance on patients suffering from GDM:1)Blood sugar:Blood glucose control was effective with nutritional dietary guidance for 1 week,6 weeks and 12 weeks,particularly at 1h and 2h after meals,and fasting blood glucose decreases dramatically before the delivery in the GDM intervention group.2)Blood lipids level:Compared with the control group,the GDM intervention group had a more evident improvement in related serum total cholesterol,triglyceride,high-density lipoprotein and low-density lipoprotein at 6 weeks after nutritional dietary guidance,and the difference was statistically significant.3)Insulin index:A better result of fasting blood insulin was observed at 6 weeks after nutritional dietary guidance in the GDM intervention group,and insulin index was much lower than that of the control group at 1h,2h and 3h after meals.The difference had a statistic significance;Insulin resistance index(IRI)and insulin secretion function index(IFI)of patients with GDM performed much better than those do from the control group.The difference has a statistic significance.4)Mother weight and newborn weight:After a nutritional dietary guidance,the GDM intervention group had a higher weight growth than the control group;Newborn weight was within the range of healthy standardized weight while the control group showed a much lower value.5)Gestation result:After a nutritional dietary guidance intervention,the incidence of macro somia and caesarean section declined sharply compared with the control group.And the difference was statistically significant.Conclusion:1.Individual dietary habit,dietary structure and intake of three energy nutrients of patients with GDM are unreasonable;pregnant women should adjust the unreasonable dietary structure to avoid GDM.2.During pregnancy,after a nutritional dietary guidance toward patients with GDM,blood sugar level and serum insulin resistance were improved notably;the appropriate control of blood sugar was beneficial to fetus growth,and can reduce the possibility of fetal gigantism,avoiding the caesarean section and improving the pregnancy outcome. |
PDF Full Text Request