Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Thammasat University, Khlong Luang, Thailand; Thammasat Diabetes Center, Thammasat University Hospital, Khlong Nueng, Thailand.
Department of Medicine, Faculty of Medicine, Thammasat University, Khlong Luang, Thailand.
Clin Ther. 2023 Apr;45(4):347-353. doi: 10.1016/j.clinthera.2023.02.009. Epub 2023 Mar 23.
Medical nutritional therapy is vital in patients with diabetes. A low glycemic index (GI) is generally advised in the management of women with gestational diabetes mellitus (GDM). However, the efficacy of this advice has not been systematically examined. The purpose of this study was to determine whether recommending a low to moderate GI rice (RD43 rice; GI = 56.9) in women with GDM would reduce the number of women requiring insulin, compared with rice of high GI (Thai Hom Mali [THM] rice; GI = 80.1).
Ninety-six participants with GDM were randomly assigned to receive either RD43 rice or THM rice.
The mean ± SD ages in the RD43 and THM groups were 33.1 ± 13.1 and 33.6 ± 4.1 years, respectively. The mean gestational ages at the sampling in the RD43 and THM groups were 23.3 ± 5.9 and 23.5 ± 5.4 weeks. Both groups had comparable baseline characteristics, including age, gestational age, body mass index prior to pregnancy and at enrollment, baseline postprandial (oral glucose tolerance test) plasma glucose level, and hemoglobin A. Of the 48 women assigned to the RD43 group, 3 (6.3%) required insulin; in the THM group, 11 (22.9%) met the criteria for insulin therapy (P = 0.017). However, 10 of these 11 women were able to avoid insulin use by changing to the low to moderate GI rice.
Using a low to moderate GI rice in GDM effectively reduced the number of patients requiring insulin therapy. Thai Clinical Trials Registry ID: TCTR20210524007.
医学营养疗法对糖尿病患者至关重要。一般建议患有妊娠期糖尿病(GDM)的女性采用低血糖指数(GI)饮食。然而,这一建议的疗效尚未得到系统检验。本研究旨在确定与高 GI(泰国茉莉香米,GI=80.1)相比,建议 GDM 女性食用低-中 GI(RD43 米,GI=56.9)是否会减少需要胰岛素治疗的女性数量。
96 名 GDM 患者被随机分为 RD43 米组或 THM 米组。
RD43 组和 THM 组的平均年龄分别为 33.1±13.1 岁和 33.6±4.1 岁。RD43 组和 THM 组的平均孕龄分别为 23.3±5.9 周和 23.5±5.4 周。两组基线特征相当,包括年龄、孕龄、妊娠前和入组时的体重指数、基线餐后(口服葡萄糖耐量试验)血糖水平和血红蛋白 A。在被分配到 RD43 组的 48 名女性中,有 3 名(6.3%)需要胰岛素;在 THM 组中,有 11 名(22.9%)符合胰岛素治疗标准(P=0.017)。然而,这 11 名女性中有 10 名通过改用低-中 GI 米避免了使用胰岛素。
在 GDM 中使用低-中 GI 米可有效减少需要胰岛素治疗的患者数量。泰国临床试验注册中心 ID:TCTR20210524007。