摘要
目的:探讨维生素D联合膳食管理对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖控制及产妇和胎儿妊娠结局的影响。方法:选取2022年5月—2023年5月在我院妇产科门诊定期产检的128例患有GDM的孕妇为研究对象,采用随机数字表法将128例孕妇随机分为观察组和对照组各64例。对照组接受临床常规治疗和健康宣教,观察组在此基础上给予维生素D (400 IU/次,1次/d)联合膳食管理干预,观察并比较两组血糖控制情况,包括空腹血糖(FBG)、餐后2 h血糖水平(2h PG)、糖化血红蛋白(HbA1c),胰岛素抵抗情况,包括空腹胰岛素(FINs)和胰岛素抵抗指数(HOMA-IR),以及孕妇和胎儿的妊娠结局。结果:观察组与对照组孕妇在年龄、孕周、BMI、文化程度、叶酸补充情况、规律运动及每日户外活动时间上均无差异(P>0.05)。干预前两组患者FBG、HbA1c、2h PG、HOMA-IR及FINS水平无差异,组间比较无统计学意义(P>0.05)。经干预后,两组患者上述指标均下降,且经维生素D及膳食管理干预的观察组孕妇下降程度显著高于对照组(P<0.05),产妇(4.69%vs32.81%)及胎儿(3.13%vs 31.25%)不良妊娠结局发生率也显著低于对照组(P<0.001)。结论:维生素D联合膳食管理辅助治疗可控制GDM患者血糖水平,降低胰岛素抵抗,降低产妇和胎儿不良妊娠结局的发生率。
【Objective】To investigate the effect of vitamin D combined with dietary management on glycaemic control and maternal and fetal pregnancy outcomes in patients with gestational diabetes mellitus(GDM).【Method】Totally128 pregnant women with GDM who had regular obstetrics and gynaecology outpatient checkups in the Department of Obstetrics and Gynaecology of Our Hospital were selected as the study subjects,and 128 pregnant women were randomly divided into 64 cases each in the observation group and the control group by using the random number table method.The control group received routine clinical treatment and health education,while the observation group was given vitamin D(400 IU/dose,1 time/day)combined with dietary management intervention,and the two groups were observed and compared in terms of glycemic control as well as maternal and fetal pregnancy outcomes.【Result】There was no difference between pregnant women in the observation group and the control group in terms of age,gestational week,BMI,education level,folic acid supplementation,regular exercise and daily outdoor activity time(P>0.05).There was no difference in the levels of FBG,HbA1c,2 h PG,HOMA-IR and FINS between the two groups before intervention,and the comparison between the groups was not statistically significant(P>0.05).After the intervention,the above indicators decreased in both groups,and the degree of decrease in pregnant women in the observation group with vitamin D and dietary management intervention was significantly higher than that in the control group(P<0.05),and the incidence of adverse pregnancy outcomes in mothers(4.69%vs.32.81%)and foetuses(3.13%vs.31.25%)was also significantly lower than that in the control group(P<0.001).【Conclusion】Vitamin D combined with dietary management adjuvant therapy can control blood glucose levels in GDM patients,reduce insulin resistance,and decrease the incidence of maternal and fetal adverse pregnancy outcomes.
作者
张华俊
袁建娜
王薇
ZHANG Hua-jun;YUAN Jian-na;WANG Wei(Pharmacy Department,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao 066000,China)
出处
《中国食物与营养》
2024年第3期56-59,共4页
Food and Nutrition in China
基金
河北省医学科学研究重点课题计划项目(项目编号:20241721)。
关键词
维生素D
妊娠期糖尿病
干预
妊娠结局
血糖
胰岛素抵抗
vitamin D
gestational diabetes mellitus(GDM)
intervention intervention
pregnancy outcome
blood glucose
insulin resistance
作者简介
张华俊(1983-),女,硕士,副主任药师,研究方向:药理学。
