| Gestational diabetes mellitus(GDM)refers to different degrees of abnormal glucose tolerance occurring or first detected during pregnancy.Pregnant women with gestational diabetes often have no obvious symptoms.However,the disease can bring a series of adverse maternal and fetal outcomes.Studies have shown that as women’s blood glucose levels during pregnancy increase,the risks of preeclampsia,premature delivery,neonatal hypoglycemia,and delivery of babies older than gestational age also increase.The blood sugar of the vast majority of women with gestational diabetes can return to normal after delivery,but there are still a small number of people who will develop diabetes,and the offspring of patients with gestational diabetes will have a significantly increased risk of developing type 2 diabetes and metabolic syndrome in the future.Gestational diabetes mellitus seriously harms the health of mother and children,and brings huge economic burden to the family.Studies have shown that effective treatment of gestational diabetes can significantly reduce complications in both mothers and children.In recent years,with the increasing incidence of gestational diabetes,how to effectively manage patients with gestational diabetes,effectively control blood glucose and reduce adverse outcomes of mothers and children have become difficult problems for the majority of medical staff.PDCA cycle is a quality management method proposed by Deming,an American quality management expert.Its basic characteristics are scientific,procedural and standardized.The four stages of PDCA cycle,namely Plan,Do,Check and Action,are an organic whole,connected with each other and promoting each other.Continuous quality improvement can be carried out in this order,and the quality of work can be improved in the continuous cycle.With the successful application of PDCA cycle in quality work,PDCA cycle mode has been gradually applied in the medical field,and achieved good results.At present,the application of PDCA cycle in the management of gestational diabetes mellitus has not received clinical attention,and there is still a lack of clinical data to support the application of PDCA cycle in the management of this disease.ObjectiveTo explore and analyze the effect of PDCA cycling nutrition management in patients with GDM,to explore the advantages of PDCA cycling nutrition management compared with conventional management,and to evaluate the clinical application value of PDCA cycling in the management of gestational diabetes mellitus,in order to provide clinical basis for improving the management mode of GDM.MethodsIn this study,260 patients with GDM from the Third Affiliated Hospital of Zhengzhou University were selected.They were numbered according to the order of inclusion in the study and divided into study group and control group by random number table method,with 130 patients in each group.In the control group,routine management of gestational diabetes mellitus was adopted.While the study group applied PDCA cycle nutrition management mode on the basis of the routine management of the control group.Effect evaluation indexes included blood glucose level,nutritional indexes,psychological scale score,weight gain during pregnancy,incidence of adverse outcomes of mothers,delivery mode,neonatal outcome and 42-day neonatal physical development indexes.SPSS 25.0 software was used for data analysis.Quantitative data were represented by (?)±s,qualitative data by n and%.Comparison between two quantitative data groups was conducted by t test,and comparison between two qualitative data groups was conducted byχ~2 test or Fisher’s exact probability method.All statistical tests in this study were bilateral,with a=0.05 as the test standard.Results1.The two groups of patients were not statistically significant in age,residence,parity,pre-pregnancy BMI,blood pressure,family history of diabetes and uterine scar(P>0.05).2.Before intervention,there were no statistically significant differences in fasting blood glucose,OGTT 1h blood glucose,OGTT 2h blood glucose,hemoglobin,total protein,serum albumin,pre-albumin,anxiety score and depression score between two groups(P>0.05).3.After the intervention,the fasting blood glucose,glycosylated hemoglobin,blood glucose 2 hours after meals,and blood glucose before sleep of the study group were lower than those of the control group,the difference was statistically significant(P<0.05).4.After the intervention,the total protein,serum albumin,and prealbumin of the study group were higher than those of the control group before delivery,the difference was statistically significant(P<0.05),the hemoglobin of the study group was higher than that of the control group,but the difference was not statistically significant(P>0.05).5.After the intervention,the anxiety score and depression score of the study group were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).6.After the intervention,the average weekly weight gain and overall weight gain during pregnancy of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).7.After the intervention,the incidence of hypertension,premature rupture of membranes,and insulin for injection in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).8.After the intervention,there was no statistically significant difference between the two groups in terms of delivery gestational age and mode of delivery(P>0.05).9.After the intervention,the incidence of neonatal hypoglycemia,macrosomia,large for gestational age infant,small for gestational age infant,and neonatal transfer to NICU in the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).10.After the intervention,the 42-day net increase in weight,length and head circumference of the newborns in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusions1.PDCA circulation nutrition management can effectively control the blood glucose level of GDM patients,improve the psychological state of GDM patients,and better control the growth of body weight of GDM patients during pregnancy.2.PDCA circulation nutrition management can significantly reduce the incidence of adverse outcomes in mothers and infants of GDM patients,improve maternal and infant outcomes,and may play a certain role in promoting the physical development of newborns. |
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