Liu Bei, Jia Ge, Cai Fengcheng
Childbirth Center, Hangzhou Women's Hospital, Hangzhou, 310008, People's Republic of China.
J Multidiscip Healthc. 2025 Jun 9;18:3311-3320. doi: 10.2147/JMDH.S525616. eCollection 2025.
To analyze the application of a shared decision-making (SDM)-based exercise management program in patients with gestational diabetes mellitus (GDM) and its impact on blood glucose control.
A retrospective analysis was conducted on the clinical data of 88 GDM patients who delivered at the Hangzhou Women's Hospitalbetween December 2022 and April 2024. Patients were divided into the control group (n=44, receiving conventional exercise management program) and the observation group (n=44, receiving SDM-based exercise management program). Compliance with medical advice, quality of life (DSQL), self-management ability (SDSCA), blood glucose indicators (FBG, 2 h PG, and HbAlc), adverse self-management behaviors, and maternal and neonatal pregnancy outcomes were compared between the two groups.
The observation group had higher rates of standardized medication use, scientific diet, regular blood glucose monitoring, adherence to exercise, and regular sleep patterns compared to the control group (P<0.05). After intervention, the DSQL scores in both groups decreased, while the SDSCA scores increased, with the observation group showing a greater change (P<0.05). The FBG, 2 h PG, and HbAlc levels were all lower after intervention in both groups, with the observation group showing a greater change (P<0.05). The observation group had lower rates of poor blood glucose control, excessive weight gain during pregnancy, and unsatisfactory post-delivery oral glucose tolerance test (OGTT) compared to the control group (P<0.05). The total incidence of adverse maternal pregnancy outcomes and neonatal adverse pregnancy outcomes was also lower in the observation group compared to the control group (P<0.05).
Compared to conventional exercise management programs, the SDM-based individualized exercise management program can further improve GDM patients' compliance with medical advice, enhance self-management abilities and quality of life, regulate blood glucose control, and improve maternal and neonatal pregnancy outcomes.
分析基于共同决策（SDM）的运动管理方案在妊娠期糖尿病（GDM）患者中的应用及其对血糖控制的影响。
对2022年12月至2024年4月在杭州市妇产科医院分娩的88例GDM患者的临床资料进行回顾性分析。将患者分为对照组（n = 44，接受常规运动管理方案）和观察组（n = 44，接受基于SDM的运动管理方案）。比较两组患者的医嘱依从性、生活质量（DSQL）、自我管理能力（SDSCA）、血糖指标（空腹血糖、餐后2小时血糖和糖化血红蛋白）、不良自我管理行为以及母婴妊娠结局。
与对照组相比，观察组在规范用药、科学饮食、定期血糖监测、坚持运动和规律睡眠模式方面的比例更高（P < 0.05）。干预后，两组的DSQL评分均下降，而SDSCA评分均上升，观察组变化更明显（P < 0.05）。两组干预后的空腹血糖、餐后2小时血糖和糖化血红蛋白水平均降低，观察组变化更明显（P < 0.05）。与对照组相比，观察组血糖控制不佳、孕期体重过度增加和产后口服葡萄糖耐量试验（OGTT）不满意的发生率更低（P < 0.05）。观察组的孕产妇不良妊娠结局和新生儿不良妊娠结局的总发生率也低于对照组（P < 0.05）。
与传统运动管理方案相比，基于SDM的个体化运动管理方案可进一步提高GDM患者的医嘱依从性，增强自我管理能力和生活质量，调节血糖控制，并改善母婴妊娠结局。
