Zekai Tahir Burak Women Health Education and Research Hospital, Ankara, Turkey.
Eur Rev Med Pharmacol Sci. 2013 May;17(9):1258-61.
Gestational diabetes mellitus (GDM) is defined as glucose intolerance, first time detected in pregnancy. Diagnostic criteria for GDM have changed over the decades. The aim of the study was to examine the effect of diet on birth weight, number of large for gestational age (LGA) (birth weight > 90th percentile) babies, total maternal weight gain, gestational age and route of delivery among patients with positive 50 g glucose challenge test (GCT) and negative 100 g oral glucose tolerance test (OGTT).
A prospective randomized controlled study was conducted among patients with positive 50 g GCT and negative 100 g OGTT. A plasma glucose value of 140 mg/dL was used as the threshold to define an abnormal GCT result. In group 1 50 patients were given a caloric diet and compared with group 2 with 50 patients without a given diet. Patients were followed up until delivery and evaluated for birth weight, number of LGA babies, total maternal weight gain, gestational age and route of delivery.
There were no significant differences between the groups in maternal age, parity, body mass index and gestational age at delivery. There were significant differences in birth weight, number of LGA babies, total maternal weight gain during pregnancy. The mean gestational age at delivery was 38.7±1.2 weeks in group 1 and 38.9±1.1 weeks in group 2 (p = 0.615). The mean birth weight in group 1 was 3328±399 g and 3623±485 g in group 2 (p = 0.007), cesarean rate was 32% in group 1 and 40% in group 2 (p = 0.405).
In the management of patients with positive 50 g GCT and negative 100 g OGTT, patients who were prescribed medical nutrition therapy by a dietitian experienced in GDM management had better perinatal outcomes.
妊娠期糖尿病（GDM）是指在怀孕期间首次发现的葡萄糖不耐受。GDM 的诊断标准在过去几十年中发生了变化。本研究的目的是研究饮食对阳性 50g 葡萄糖筛查试验（GCT）和阴性 100g 口服葡萄糖耐量试验（OGTT）患者的出生体重、巨大儿（出生体重>第 90 百分位）的数量、总孕妇体重增加、妊娠周数和分娩方式的影响。
对阳性 50gGCT 和阴性 100gOGTT 的患者进行前瞻性随机对照研究。以 140mg/dL 的血浆葡萄糖值作为异常 GCT 结果的阈值。在第 1 组 50 例患者给予热量饮食，并与第 2 组 50 例未给予饮食的患者进行比较。患者随访至分娩，并评估出生体重、巨大儿数量、孕妇总体重增加、妊娠周数和分娩方式。
两组患者的母亲年龄、产次、体重指数和分娩时的妊娠周数无显著差异。出生体重、巨大儿数量、孕期总体重增加有显著差异。第 1 组的平均分娩孕周为 38.7±1.2 周，第 2 组为 38.9±1.1 周（p=0.615）。第 1 组的平均出生体重为 3328±399g，第 2 组为 3623±485g（p=0.007），第 1 组剖宫产率为 32%，第 2 组为 40%（p=0.405）。
在管理阳性 50gGCT 和阴性 100gOGTT 的患者时，由在 GDM 管理方面经验丰富的营养师开具医疗营养治疗方案的患者有更好的围产期结局。
