妊娠期糖尿病和糖耐量减低的营养治疗研究

目的:研究营养治疗对妊娠期糖尿病(GDM)和糖耐量减低(IGT)的意义.方法:对来我院围产检查并分娩的610例孕妇,采用50 g葡萄糖负荷试验(GCT)筛查,阳性者再行口服葡萄糖耐量试验(OGTT),以诊断GDM和IGT;对于GDM和IGT进行严格饮食控制,监测其空腹和餐后2 h血糖变化情况,并跟踪其围生期病死率、巨大儿和新生儿患病率情况.结果:50 g GCT阳性者140例,其中确诊为GDM 15例,IGT 61例;饮食控制后GDM组空腹和餐后2 h血糖均有明显下降(P＜0.05);IGT组餐后2 h血糖有明显下降(P＜0.05).两组的围生期病死率、巨大儿和新生儿患病率均低于国内相关文献报道,其中IGT组的巨大儿和新生儿患病率均低于GDM组(P＜0.05).结论:对所有孕妇应做50 g GCT筛查;严格合理的饮食控制对GDM和IGT的血糖控制和妊娠结局具有重要意义.

Nutritional therapy of gestational diabetes mellitus and impaired glucose tolerance

Objective:To study the nutritional therapy of GDM and IGT.Methods:50 g glucose challenge test was done 610 in patients at examination in our hospital.The oral glucose tolerance test(OGTT)was performed in glucose challenge test positive patients to diagnose GDM and IGT.The blood glucose of fasting and postprandial 2h,perinatal mortality,incidence of large neonates were observed after treatment with nutrition in the GDM and IGT patients.Results:There were 15 cases of GDM and 61cases of IGT during the 140 cases of GCT positive patients.After nutritional therapy,the GDM's fasting and postprandial 2 h blood glucose decreased significantly(P<0.05),and the IGT's postprandial 2 h blood glucose decreased significantly(P<0.05). The perinatal mortality,incidence of large neonates in both of the GDM and IGT were lowered.The incidence of large neonates in IGT patients was lowered((P<0.05)).Conclusion:50 g glucose screening test is necessary for all pregnant women.It is important for the GDM and IGT patients to control blood glucose with reasonable nutritional therapy.