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妊娠期糖尿病:饮食中碳水化合物质量的影响。

Gestational Diabetes Mellitus: The Impact of Carbohydrate Quality in Diet.

机构信息

Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy.

Department of Movement, Human and Health Sciences, Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma "Foro Italico", 00135 Rome, Italy.

出版信息

Nutrients. 2019 Jul 9;11(7):1549. doi: 10.3390/nu11071549.

Abstract

Gestational diabetes mellitus (GDM) is defined as "glucose intolerance that is first diagnosed during pregnancy". Mothers with GDM and their infants may experience both short and long term complications. Dietary intervention is the first therapeutic strategy. If good glycaemic control is not achieved, insulin therapy is recommended. There is no consensus on which nutritional approach should be used in GDM. In the last few years, there has been growing evidence of the benefits of a low glycaemic index (LGI) diet on diabetes and cardiovascular disease. The effect of a LGI diet on GDM incidence has been investigated as well. Several studies observed a lower incidence of GDM in LGI diet arms, without adverse maternal and fetal outcomes. The main positive effect of the LGI diet was the reduction of 2-h post-prandial glucose (PPG). Several studies have also evaluated the effect of the LGI diet in GDM treatment. Overall, the LGI diet might have beneficial effects on certain outcomes, such as 2-h PPG, fasting plasma glucose and lipid profile in patients with GDM. Indeed, most studies observed a significant reduction in insulin requirement. Overall, according to current evidence, the LGI nutritional approach is safe and it might therefore be considered in clinical care for GDM.

摘要

妊娠期糖尿病(GDM)定义为“在怀孕期间首次诊断出的葡萄糖不耐受”。患有 GDM 的母亲及其婴儿可能会出现短期和长期并发症。饮食干预是首要的治疗策略。如果不能达到良好的血糖控制,建议使用胰岛素治疗。对于 GDM 应该采用哪种营养方法,目前尚无共识。在过去几年中,越来越多的证据表明低升糖指数(LGI)饮食对糖尿病和心血管疾病有益。LGI 饮食对 GDM 发病率的影响也已被研究。一些研究观察到 LGI 饮食组的 GDM 发病率较低,且母婴结局无不良影响。LGI 饮食的主要积极作用是降低餐后 2 小时血糖(PPG)。一些研究还评估了 LGI 饮食在 GDM 治疗中的作用。总的来说,LGI 饮食可能对某些结果有益,例如 GDM 患者的 2 小时 PPG、空腹血糖和血脂谱。实际上,大多数研究观察到胰岛素需求显著降低。总体而言,根据现有证据,LGI 营养方法是安全的,因此可以在 GDM 的临床护理中考虑。

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