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妊娠期糖尿病管理营养策略的进展:近期证据的系统评价

Advancements in Nutritional Strategies for Gestational Diabetes Management: A Systematic Review of Recent Evidence.

作者信息

Sánchez-García Juan Carlos, Saraceno López-Palop Ines, Piqueras-Sola Beatriz, Cortés-Martín Jonathan, Mellado-García Elena, Muñóz Sánchez Inmaculada, Rodríguez-Blanque Raquel

机构信息

Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain.

Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain.

出版信息

J Clin Med. 2023 Dec 20;13(1):37. doi: 10.3390/jcm13010037.

Abstract

Gestational diabetes mellitus (GDM) is defined as hyperglycaemia first detected at any time during pregnancy with values lower than those determined by the WHO for diabetes diagnosis in adults. This pathology, with a worldwide prevalence of 13.4%, causes significant maternal and foetal risks. The first line of treatment consists of maintaining normo-glycaemia through an adequate diet and lifestyle changes. The aim is to synthesize the scientific evidence updating the nutritional recommendations for the effective management of GDM. A systematic review of the scientific literature was conducted following the PRISMA guidelines. Randomized clinical trials published within the last five years and providing information on nutritional recommendations to achieve an effective management of gestational diabetes were selected. The databases searched were PubMed, the WOS Core Collection, SCOPUS, and CINAHL, using the MeSH terms: "Diabetes, Gestational"; "Nutrition Assessment (nutrition*)"; "Diet"; "Eating"; and "Food"; with the Boolean operators "AND" and "OR". The PEDro scale (Physiotherapy Evidence Database) was used to assess the scientific quality of the studies, with a mean score of 8.9, indicating an average good scientific quality. Results: A total of 809 papers were collected, of which, after applying the inclusion and exclusion criteria, 14 randomized clinical trials were selected. Probiotic supplementation and co-supplementation with vitamin D have been found to be the most beneficial options for both mothers with GDM and neonates, but the most effective regimens are not known. Diets enriched with extra virgin olive oil (EVOO) and oat bran, as well as some recommendations focused on carbohydrates also seem effective, as well as diets designed for this group of women with GDM such as "CHOICE". Conclusions: Although there are numerous proposals that have been published in recent years focused on the diet of women with GDM in order to improve their results and those of their children, it is the supplementation with probiotics and the co-supplementation with vitamin D that is most agreed upon as beneficial; however, more research is needed into which protocols are most effective. Other proposals that could also be beneficial should be further studied.

摘要

妊娠期糖尿病(GDM)被定义为在孕期任何时间首次检测到的高血糖,其值低于世界卫生组织(WHO)规定的成人糖尿病诊断值。这种疾病在全球的患病率为13.4%,会导致重大的母婴风险。一线治疗包括通过适当的饮食和生活方式改变来维持血糖正常。目的是综合科学证据,更新有效管理GDM的营养建议。按照PRISMA指南对科学文献进行了系统综述。选择了过去五年内发表的、提供有关实现妊娠期糖尿病有效管理的营养建议信息的随机临床试验。检索的数据库有PubMed、WOS核心合集、SCOPUS和CINAHL,使用的医学主题词为:“妊娠期糖尿病”;“营养评估(nutrition*)”;“饮食”;“进食”;和“食物”,并使用布尔运算符“AND”和“OR”。使用PEDro量表(物理治疗证据数据库)评估研究的科学质量,平均得分为8.9,表明科学质量总体良好。结果:共收集到809篇论文,应用纳入和排除标准后,选择了14项随机临床试验。已发现补充益生菌和联合补充维生素D对患有GDM的母亲和新生儿都是最有益的选择,但最有效的方案尚不清楚。富含特级初榨橄榄油(EVOO)和燕麦麸的饮食,以及一些针对碳水化合物的建议似乎也有效,还有为患有GDM的女性群体设计的饮食,如“CHOICE”饮食。结论:尽管近年来发表了许多关于患有GDM的女性饮食的建议,以改善她们及其子女的情况,但补充益生菌和联合补充维生素D被认为是最有益的;然而,需要更多研究来确定哪些方案最有效。其他可能有益的建议也应进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d97/10779518/8ce953b2532e/jcm-13-00037-g001.jpg

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