Dietary Intervention For Gestational Diabetes Patients Based On Smartphone Application

Objective :A smartphone application called “Sugar control medicine” was designed and developed,and the procedure was used for dietary intervention in patients with gestational diabetes mellitus.The intervention effect was evaluated by comparing the changes of blood glucose,insulin use,body weight,self-efficacy and the incidence of maternal and child adverse outcomes in patients with gestational diabetes before and after intervention.Methods :A total of 156 patients with gestational diabetes diagnosed in the Department of Endocrinology,Shanxi Provincial People's Hospital from January to September 2018 were selected by convenient sampling method.According to the random number table method,they were divided into control group and intervention group,78 cases in each group.The control group received routine guidance from the diabetes health education nurses in the outpatient clinic.The intervention group used the smartphone application for diet management based on routine guidance.And evaluated the blood glucose,insulin use,weight gain,maternal and infant outcomes and self-efficacy of the two groups before and after the intervention.Results:(1)Before the intervention,there was no significant difference in general data,blood glucose,body mass index and self-efficacy score between the two groups(P>0.05).(2)The blood glucose difference between the two groups of gestational diabetespatients before intervention,6 weeks after intervention and 12 weeks after intervention was compared by repetitive measure ANOVA.The results were statistically significant(P<0.05).There were significant differences in Fasting blood glucose,One-hour Plasma Glucose and Two-hour Plasma Glucose between the two groups at different time points(F=158.969,F=901.350,F=566.619,P<0.001),that is,regardless of the inter-group effect,the blood glucose levels of the two groups of patients gradually decreased with time;there was an interaction between time and group(F=14.020,F=39.517,F=76.626,P<0.001);And further analysis of individual effects,under fixed time conditions,the results showed that there was no significant difference in blood glucose values between the two groups of gestational diabetes patients before intervention(P>0.05);intergroup effect(F=6.376,F=10.445,F= 13.536,P<0.05),that is,regardless of the time effect,the blood glucose levels of the two groups of patients have different degrees of decline.After 12 weeks of intervention,the glycosylated hemoglobin index of the intervention group was better than that of the control group after intervention(P<0.05).(3)There were no significant differences in the number of patients treated with insulin in the intervention group and the control group after 12 weeks(P>0.05),but the dose of insulin in the intervention group was lower than that in the control group.The difference was statistically significant(P<0.05).(4)The body mass index and the weight gain after intervention in the gestational diabetes patients in the intervention group were superior to the control group,and the difference was statistically significant(P<0.05).(5)There was no significant difference in the incidence of premature rupture of membranes between the two groups of gestational diabetes mellitus(P>0.05).The incidence of cesarean section,polyhydramnios,puerperal infection and gestational hypertension was lower in the intervention group than in the control group.The difference was statistically significant(P<0.05).The incidence of adverse outcomes in perinatal infants in the intervention group was lower than that in the control group,and the difference was statistically significant(P<0.05).(6)After 12 weeks of intervention,the self-efficacy score of the intervention group was better than that of the control group,and the differences were statistically significant(P<0.05).Conclusions:Applying the smartphone application to dietary intervention is beneficial to control the blood sugar level,reduce the dose of insulin,control weight gain of gestational diabetes patients,reduce the incidence of maternal and child adverse outcomes,and improve the patient's self-efficacy level,which is worthy of application and promotion in clinical work.