Jovanovic-Peterson L, Durak E P, Peterson C M
Sansum Medical Research Foundation, Santa Barbara, CA 93105.
Am J Obstet Gynecol. 1989 Aug;161(2):415-9. doi: 10.1016/0002-9378(89)90534-6.
We studied the impact of a training program on glucose tolerance in gestational diabetes mellitus. Women with gestational diabetes mellitus (N = 19) were randomized into either group I, a 6-week diet alone group (24 to 30 kcal/kg/24 hours; 20% protein, 40% carbohydrate, 40% fat), or group II, which followed the same diet plus exercise (20 minutes three times a week for 6 weeks). An arm ergometer was used to maintain heart rate in the training range. Glycemic response was monitored by glycosylated hemoglobin, a 50 gm oral glucose challenge with a fasting and 1-hour plasma glucose, and blood glucose self-monitoring, fasting and 1 hour after meals. Week 1 glycemic parameters were the same for both groups. Week 6 data (mean +/- SD) were as follows: group I glycosylated hemoglobin, 4.7% + 0.2% versus group II, 4.2% +/- 0.2%; p less than 0.001. The group I glucose challenge fasting value was 87.6 +/- 6.2 versus 70.1 +/- 6.6 mg/dl, p less than 0.001 for group II. The group I 1-hour plasma glucose challenge result was 187.5 +/- 12.9 mg/dl versus 105.9 +/- 18.9 mg/dl for group II, p less than 0.001. The glycemic levels diverged between the groups at week 4. We conclude that arm ergometer training is feasible in women with gestational diabetes mellitus and results in lower glycosylated hemoglobin, fasting, and 1-hour plasma glucose concentrations than diet alone. Arm ergometer training may provide a useful treatment option for women with gestational diabetes mellitus and may obviate insulin treatment.
我们研究了一项培训计划对妊娠期糖尿病患者糖耐量的影响。将患有妊娠期糖尿病的女性（N = 19）随机分为两组，第一组为仅饮食组，为期6周（24至30千卡/千克/24小时；20%蛋白质，40%碳水化合物，40%脂肪），第二组除遵循相同饮食外还进行运动（每周三次，每次20分钟，共6周）。使用手臂测力计将心率维持在训练范围内。通过糖化血红蛋白、50克口服葡萄糖耐量试验（空腹及1小时血浆葡萄糖）以及血糖自我监测（空腹及餐后1小时）来监测血糖反应。两组在第1周的血糖参数相同。第6周的数据（平均值±标准差）如下：第一组糖化血红蛋白为4.7% + 0.2%，第二组为4.2% ± 0.2%；p < 0.001。第一组葡萄糖耐量试验的空腹值为87.6 ± 6.2，第二组为70.1 ± 6.6毫克/分升，p < 0.001。第一组1小时血浆葡萄糖耐量试验结果为187.5 ± 12.9毫克/分升，第二组为105.9 ± 18.9毫克/分升，p < 0.001。两组血糖水平在第4周出现差异。我们得出结论，对于患有妊娠期糖尿病的女性，手臂测力计训练是可行的，与单纯饮食相比，可降低糖化血红蛋白、空腹及1小时血浆葡萄糖浓度。手臂测力计训练可能为患有妊娠期糖尿病的女性提供一种有用的治疗选择，并且可能避免胰岛素治疗。
