Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9 - 4001, 2100 Copenhagen Ø, Denmark; Department of Endocrinology, Rigshospitalet, Ole Måløes Vej 24 - 7551, 2100 Copenhagen Ø, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark.
Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9 - 4001, 2100 Copenhagen Ø, Denmark; The Nutrition Unit, Rigshospitalet, Henrik Harpestrengs Vej 4 - 5711, 2100 Copenhagen Ø, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 Copenhagen N, Denmark.
Diabetes Res Clin Pract. 2017 May;127:97-104. doi: 10.1016/j.diabres.2016.12.012. Epub 2016 Dec 23.
To study the influence of the quantity and the quality of carbohydrate consumption on glycemic control in early pregnancy among women with type 1 diabetes.
A retrospective study of 107 women with type 1 diabetes who completed 1-3days of diet recording before first antenatal visit, as a part of routine care. The total daily carbohydrate consumption from the major sources (e.g. bread, potatoes, rice, pasta, dairy products, fruits, candy) was calculated. A dietician estimated the overall glycemic index score (scale 0-7).
At least two days of diet recording were available in 75% of the 107 women at mean 64 (SD±14) gestational days. The quantity of carbohydrate consumption from major sources was 180 (±51)g/day. HbA1c was positively associated with the quantity of carbohydrate consumption (β=0.41; 95% CI 0.13-0.70, P=0.005), corresponding to an increase of 0.4% in HbA1c per 100g carbohydrates consumed daily, when adjusted for insulin dose/bodyweight and use of insulin pump treatment. The median (IQR) glycemic index score was 2 (0-3). An adjusted association between HbA1c and glycemic index score was not demonstrated. The women using carbohydrate counting daily (45%) had lower HbA1c compared to the remaining women (6.4 (±0.5) vs. 6.8 (±0.9)% (47±6 vs. 51±10mmol/mol), P=0.01).
HbA1c in early pregnancy was positively associated with the quantity of carbohydrate consumption regardless of insulin treatment. Carbohydrate counting is probably important for glycemic control in pregnant women with type 1 diabetes.
研究 1 型糖尿病女性妊娠早期碳水化合物摄入量和质量对血糖控制的影响。
对 107 例在首次产前检查前完成 1-3 天饮食记录的 1 型糖尿病女性进行回顾性研究，这是常规护理的一部分。从主要来源（如面包、土豆、米饭、意大利面、奶制品、水果、糖果）计算每日总碳水化合物摄入量。营养师估计总的血糖指数评分（0-7 分）。
在 107 例女性中，75%至少有两天的饮食记录，平均妊娠 64（SD±14）天。主要来源的碳水化合物摄入量为 180（±51）g/天。HbA1c 与碳水化合物摄入量呈正相关（β=0.41；95%CI 0.13-0.70，P=0.005），调整胰岛素剂量/体重和胰岛素泵治疗的使用后，每日每 100g 碳水化合物摄入增加 0.4%，HbA1c 相应增加 0.4%。中位数（IQR）血糖指数评分 2（0-3）。未发现 HbA1c 与血糖指数评分之间的调整关联。每天进行碳水化合物计数的女性（45%）的 HbA1c 低于其余女性（6.4（±0.5）%比 6.8（±0.9）%（47±6 比 51±10mmol/mol），P=0.01）。
妊娠早期的 HbA1c 与碳水化合物摄入量呈正相关，与胰岛素治疗无关。对于 1 型糖尿病孕妇，碳水化合物计数可能对血糖控制很重要。
