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生活方式改变对妊娠期糖尿病孕妇血糖控制的有效性

The Effectiveness of Lifestyle Changes in Glycemic Control among Pregnant Women with Gestational Diabetes Mellitus.

作者信息

Le Duc Cuong, Vu Thanh Binh, Tran Thi Nuong, Nguyen Thi Ly, Nguyen Thanh Binh, Nguyen Duy Cuong, Hoang Van Thuan

机构信息

Thai Binh University of Medicine and Pharmacy, Thai Binh 410000, Vietnam.

出版信息

Medicina (Kaunas). 2023 Sep 1;59(9):1587. doi: 10.3390/medicina59091587.

Abstract

: Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy and affects approximately 10% of pregnant women worldwide. Understanding the impact of lifestyle changes on glycemic control in GDM is important for improving maternal and fetal outcomes and reducing the risk of diabetes in both the mother and child. The aim of this study is to evaluate the effectiveness as well as the factors affecting glycemic control by lifestyle changes in pregnant women with GDM. : A descriptive cross-sectional study was conducted at three hospitals in the Thai Binh Province from June 2021 to May 2022. All pregnant women at 24-28 weeks of gestation, aged 18 years or older, were enrolled. GDM was diagnosed according to the guidelines of the International Association of the Diabetes and Pregnancy Study Groups. Lifestyle changes including diet and physical exercise were carried out for two weeks. The main outcome measured was successful glycemic control according to the 2018 ADA Recommendations for the Management and Treatment of GDM. : 1035 women were included and 20.2% diagnosed with GDM. After two weeks of lifestyle change intervention, 82.6% of the pregnant women with GDM had successful glycemic control. Pregnant women aged under 35 years had a 3.2 times higher rate of gestational glycemic control than those older than 35 (aOR = 3.22, -value = 0.004). Women with a pre-pregnancy BMI of less than 25 had a higher rate of gestational glycemic control than those with a BMI of over 25 (aOR = 10.84, -value < 0.001). Compared to women who had all three diagnostic criteria for gestational diabetes, those with two diagnostic criteria and one criterion were 3.8 times and 3 times more likely to have successful blood sugar control (aOR = 3.78, -value = 0.01 and aOR = 3.03, -value = 0.03, respectively). : Lifestyle changes can be an effective measure for achieving glycemic control in women with GDM. Healthcare providers should consider individualized treatment plans based on the specific needs of each patient.

摘要

妊娠期糖尿病(GDM)是一种在孕期发生的糖尿病,全球约10%的孕妇受其影响。了解生活方式改变对GDM患者血糖控制的影响,对于改善母婴结局以及降低母婴患糖尿病的风险至关重要。本研究旨在评估生活方式改变对GDM孕妇血糖控制的有效性及其影响因素。

2021年6月至2022年5月,在太平省的三家医院开展了一项描述性横断面研究。纳入所有妊娠24 - 28周、年龄18岁及以上的孕妇。GDM根据国际糖尿病与妊娠研究组协会的指南进行诊断。进行了为期两周包括饮食和体育锻炼在内的生活方式改变。主要测量指标是根据2018年美国糖尿病协会(ADA)关于GDM管理与治疗的建议实现血糖成功控制。

共纳入1035名女性,其中20.2%被诊断为GDM。经过两周的生活方式改变干预后,82.6%的GDM孕妇实现了血糖成功控制。年龄小于35岁的孕妇孕期血糖控制率比年龄大于35岁的孕妇高3.2倍(调整后比值比[aOR]=3.22,P值=0.004)。孕前体重指数(BMI)小于25的女性孕期血糖控制率高于BMI大于25的女性(aOR = 10.84,P值<0.001)。与具有妊娠期糖尿病所有三项诊断标准的女性相比,具有两项诊断标准和一项诊断标准的女性血糖成功控制的可能性分别高3.8倍和3倍(aOR = 3.78,P值=0.01;aOR = 3.03,P值=0.03)。

生活方式改变可能是实现GDM女性血糖控制的有效措施。医疗保健提供者应根据每位患者的具体需求考虑个体化治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11a7/10537217/67e6ac157635/medicina-59-01587-g001.jpg

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