Diabetes Centre, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia.
School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.
J Hum Nutr Diet. 2022 Dec;35(6):1059-1070. doi: 10.1111/jhn.13013. Epub 2022 May 9.
The present study aimed to report Australian dietetic practice regarding management of gestational diabetes mellitus (GDM) and to make comparisons with the findings from a 2009 survey of dietitians and with the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guidelines (NPG).
Cross-sectional surveys were conducted in 2019 and 2009 of dietitians providing medical nutrition therapy (MNT) to women with GDM in Australia. The present study compares responses on demographics, dietetic assessment and interventions, and guideline use in 2019 vs. 2009.
In total, 149 dietitians (2019) and 220 (2009) met survey inclusion criteria. In both surveys >60% of respondents reported dietary interventions aiming for >45% energy from carbohydrate, 15%-25% energy from protein and 15%-30% energy from fat. Many variations in MNT found in 2009 continued to be evident in 2019, including the percentage of energy from carbohydrate aimed for (30%-65% in 2019 vs. 20%-75% in 2009) and the wide range in the recommended minimum daily carbohydrate intake (40-220 and 60-300 g). Few dietitians reported aiming for the NPG minimum of 175 g of carbohydrate daily in both surveys (32% in 2019 vs. 26% in 2009). There were, however, some significant increases in MNT consistent with NPG recommendations in 2019 vs. 2009, including the minimum frequency of visits provided (49%, n = 61 vs. 33%, n = 69; p < 0.001) and provision of gestational weight gain advice (59%, n = 95 vs. 40%, n = 195; p < 0.05).
Although many dietitians continue to provide MNT consistent with existing NPG, there is a need to support greater uptake, especially for recommendations regarding carbohydrate intake.
本研究旨在报告澳大利亚营养师在管理妊娠糖尿病（GDM）方面的实践情况，并与 2009 年对营养师的调查结果以及营养与饮食学会的循证营养实践指南（NPG）进行比较。
2019 年和 2009 年对澳大利亚提供医学营养治疗（MNT）给 GDM 女性的营养师进行了横断面调查。本研究比较了 2019 年和 2009 年在人口统计学、饮食评估和干预以及指南使用方面的回答。
共有 149 名（2019 年）和 220 名（2009 年）营养师符合调查纳入标准。在两项调查中，超过 60%的受访者报告了饮食干预措施，目标是碳水化合物提供的能量超过 45%，蛋白质提供的能量 15%-25%，脂肪提供的能量 15%-30%。2009 年发现的许多 MNT 差异在 2019 年仍然存在，包括目标碳水化合物提供的能量百分比（2019 年为 30%-65%，2009 年为 20%-75%）和推荐的最低每日碳水化合物摄入量范围（40-220 和 60-300 g）。在两项调查中，很少有营养师报告目标是 NPG 推荐的每日 175 g 碳水化合物（2019 年为 32%，2009 年为 26%）。然而，与 2009 年相比，2019 年 MNT 方面有一些显著增加，与 NPG 建议一致，包括提供的就诊最低频率（49%，n=61 比 33%，n=69；p<0.001）和提供妊娠增重建议（59%，n=95 比 40%，n=195；p<0.05）。
尽管许多营养师继续提供与现有 NPG 一致的 MNT，但仍需要支持更大程度的采用，特别是对于碳水化合物摄入量的建议。
