Duraiswamy Mahadevan, Jayaseelan Venkatachalam, Ramakrishnan Jayalakshmy, Rengaraj Sasirekha, Krishnamoorthy Yuvaraj, Kais Mohammed, Subbaiah Murali
Department of Preventive and Social Medicine, JIPMER, Puducherry, India.
Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India.
Indian J Endocrinol Metab. 2024 Nov-Dec;28(6):581-588. doi: 10.4103/ijem.ijem_314_24. Epub 2024 Dec 30.
Gestational diabetes mellitus (GDM) affects 14% of pregnancies globally, with a prevalence of 9-16% in India. Low-glycaemic index (GI) foods like millets may help control glycaemia in GDM. This study compared glycaemic control between GDM patients consuming millets once a day (MOD) and those receiving enhanced medical nutrition therapy (MNT) for 1 month.
A parallel-arm randomized controlled trial was conducted among 224 GDM mothers at a tertiary centre from April 2022 to December 2023. Participants were randomized into two groups: The Enhanced MNT group received standard care with education materials, while the MOD group received 200 g of millets daily for 1 month and recipes. Follow-ups were at 2 weeks and 1 month. The primary outcome was the difference in glycaemic control between groups, analysed with a 95% confidence interval (CI) and < 0.05 significance.
Of the 219 participants who completed the study (97.8%), adherence was 77.6% in the MOD group and 78.5% in the Enhanced MNT group. In an intention-to-treat analysis, an additional 11.6% (95% CI: -1.5% to 24.7%) in the MOD group achieved glycaemic control compared to the Enhanced MNT group, which was not statistically significant ( = 0.083). However, the MOD group had a significant mean post-prandial blood glucose reduction of -4.55 (95% CI: -8.55 to -0.56; = 0.025).
Both interventions effectively controlled glycaemic levels, with the MOD group showing slightly better post-prandial glucose control. Adherence to the protocol was high.
CTRI Registry CTRI/2022/04/042013.
妊娠期糖尿病（GDM）在全球范围内影响着14%的妊娠，在印度的患病率为9%-16%。像小米这样的低血糖指数（GI）食物可能有助于控制GDM患者的血糖水平。本研究比较了每天食用一次小米（MOD）的GDM患者与接受强化医学营养治疗（MNT）1个月的患者之间的血糖控制情况。
2022年4月至2023年12月，在一家三级中心对224名GDM母亲进行了一项平行组随机对照试验。参与者被随机分为两组：强化MNT组接受标准护理并提供教育材料，而MOD组每天接受200克小米，为期1个月，并提供食谱。随访时间为2周和1个月。主要结局是两组之间血糖控制的差异，采用95%置信区间（CI）进行分析，显著性水平<0.05。
在完成研究的219名参与者（97.8%）中，MOD组的依从率为77.6%，强化MNT组为78.5%。在意向性分析中，与强化MNT组相比，MOD组额外有11.6%（95%CI：-1.5%至24.7%）的患者实现了血糖控制，差异无统计学意义（P=0.083）。然而，MOD组餐后血糖平均显著降低了-4.55（95%CI：-8.55至-0.56；P=0.025）。
两种干预措施均有效控制了血糖水平，MOD组的餐后血糖控制略好。方案依从性较高。
CTRI注册中心CTRI/2022/04/042013。
