中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2008年
2期
86-90
,共5页
谭桂军%张菁%吴珊%张娜%宿爱琴
譚桂軍%張菁%吳珊%張娜%宿愛琴
담계군%장정%오산%장나%숙애금
糖尿病,妊娠%健康教育%糖尿病膳食%血糖指数
糖尿病,妊娠%健康教育%糖尿病膳食%血糖指數
당뇨병,임신%건강교육%당뇨병선식%혈당지수
Diabetes,gestational%Health education%Diabetic diet%Glycemic index
目的 通过营养健康教育,观察妊娠期糖尿病(gestatinoal diabetes mellitus,GDM)患者对食物血糖生成指数(glycemic index,GI)的接受程度、饮食行为改变,以及对血糖、母婴并发症发生率的影响. 方法 选择72例GDM患者作为研究对象,随机分为2组,实验组以食物GI为主要教育材料;对照组以食物交换份作为主要教育材料,采用集体讲座3次、随时电话咨询、当面答疑等方式教育至患者分娩前,观察教育前后研究对象对所授知识的接受程度、饮食行为改变、血糖变化、母儿并发症发生率. 结果 经过营养健康教育,GDM患者一致认为饮食治疗是控制血糖的首要基础,实验组接受教育后在选择食物方面,每餐选择低GI食物的百分率由13.8%提高到83.3%(P<0.01),实验组教育后三餐食物GI分别为56.1±3.5,64.2±3.3,62.7±3.1,均较教育前明显下降(P<0.01).实验组和对照组教育后空腹血糖分别为(6.3±0.6)mmol/L,(7.6±1.3)mmol/L、餐后2 h血糖分别为(7.2±0.9)mmol/L,(9.7±1.2)mmol/L,均较教育前有显著性下降[(空腹血糖:(9.2±1.6)mmol/L和(9.6±1.5)mmo/L;餐后2 h:(11.1±1.6)mmol/L和(10.6±1.2)mmol/L,P<0.01)],但实验组血糖控制更理想.实验组手术产率为58.3%(23/36)、巨大儿出生率为2.7%(1/36)、胎儿窘迫发生率为5.5%(2/36),均低于对照组(分别为28、5、9例P<0.05). 结论 营养健康教育是控制血糖的有效手段;用食物GI知识来选择食物比用食物交换份法更容易控制血糖,效果更为理想,便于在医院门诊和社区教育中广泛推广和应用;建议可将食物GI与食物交换份相结合指导GDM患者更科学、更合理的安排每日膳食.
目的 通過營養健康教育,觀察妊娠期糖尿病(gestatinoal diabetes mellitus,GDM)患者對食物血糖生成指數(glycemic index,GI)的接受程度、飲食行為改變,以及對血糖、母嬰併髮癥髮生率的影響. 方法 選擇72例GDM患者作為研究對象,隨機分為2組,實驗組以食物GI為主要教育材料;對照組以食物交換份作為主要教育材料,採用集體講座3次、隨時電話咨詢、噹麵答疑等方式教育至患者分娩前,觀察教育前後研究對象對所授知識的接受程度、飲食行為改變、血糖變化、母兒併髮癥髮生率. 結果 經過營養健康教育,GDM患者一緻認為飲食治療是控製血糖的首要基礎,實驗組接受教育後在選擇食物方麵,每餐選擇低GI食物的百分率由13.8%提高到83.3%(P<0.01),實驗組教育後三餐食物GI分彆為56.1±3.5,64.2±3.3,62.7±3.1,均較教育前明顯下降(P<0.01).實驗組和對照組教育後空腹血糖分彆為(6.3±0.6)mmol/L,(7.6±1.3)mmol/L、餐後2 h血糖分彆為(7.2±0.9)mmol/L,(9.7±1.2)mmol/L,均較教育前有顯著性下降[(空腹血糖:(9.2±1.6)mmol/L和(9.6±1.5)mmo/L;餐後2 h:(11.1±1.6)mmol/L和(10.6±1.2)mmol/L,P<0.01)],但實驗組血糖控製更理想.實驗組手術產率為58.3%(23/36)、巨大兒齣生率為2.7%(1/36)、胎兒窘迫髮生率為5.5%(2/36),均低于對照組(分彆為28、5、9例P<0.05). 結論 營養健康教育是控製血糖的有效手段;用食物GI知識來選擇食物比用食物交換份法更容易控製血糖,效果更為理想,便于在醫院門診和社區教育中廣汎推廣和應用;建議可將食物GI與食物交換份相結閤指導GDM患者更科學、更閤理的安排每日膳食.
목적 통과영양건강교육,관찰임신기당뇨병(gestatinoal diabetes mellitus,GDM)환자대식물혈당생성지수(glycemic index,GI)적접수정도、음식행위개변,이급대혈당、모영병발증발생솔적영향. 방법 선택72례GDM환자작위연구대상,수궤분위2조,실험조이식물GI위주요교육재료;대조조이식물교환빈작위주요교육재료,채용집체강좌3차、수시전화자순、당면답의등방식교육지환자분면전,관찰교육전후연구대상대소수지식적접수정도、음식행위개변、혈당변화、모인병발증발생솔. 결과 경과영양건강교육,GDM환자일치인위음식치료시공제혈당적수요기출,실험조접수교육후재선택식물방면,매찬선택저GI식물적백분솔유13.8%제고도83.3%(P<0.01),실험조교육후삼찬식물GI분별위56.1±3.5,64.2±3.3,62.7±3.1,균교교육전명현하강(P<0.01).실험조화대조조교육후공복혈당분별위(6.3±0.6)mmol/L,(7.6±1.3)mmol/L、찬후2 h혈당분별위(7.2±0.9)mmol/L,(9.7±1.2)mmol/L,균교교육전유현저성하강[(공복혈당:(9.2±1.6)mmol/L화(9.6±1.5)mmo/L;찬후2 h:(11.1±1.6)mmol/L화(10.6±1.2)mmol/L,P<0.01)],단실험조혈당공제경이상.실험조수술산솔위58.3%(23/36)、거대인출생솔위2.7%(1/36)、태인군박발생솔위5.5%(2/36),균저우대조조(분별위28、5、9례P<0.05). 결론 영양건강교육시공제혈당적유효수단;용식물GI지식래선택식물비용식물교환빈법경용역공제혈당,효과경위이상,편우재의원문진화사구교육중엄범추엄화응용;건의가장식물GI여식물교환빈상결합지도GDM환자경과학、경합리적안배매일선식.
Objective To observe the acceptibility of glycemic index(GI),diet changes in gestational diabetes mellitus(GDM)women and the effect of nutritional education on blood glucose sugar levels and the incidence of maternal and children complications. Methods Seventy-two GDM women were divided randomly into two groups.GI was used as educational material for the experimental group,while exchanging system of food was used for the control group.Health education was conducted by public lectures(3 times),telephone and face to face consultation till the time of delivery.The effects of education,diet changes,blood glucose variations and the maternal and neonatal complications were compared before and after edueation.Results After the nutritional health education,all of the women believed that dietary therapy was the basis for blood sugar control.The percentage of subject who selected GI food for each meal in the experimental group increased from 13.8% before education to 83.3%after(P<0.01).The GI in each meal every day after education was 56.1±3.5,64.2±3.3,62.7±3.1,respectively,significantly decreased than those of before(P<0.01).Fasting plasma glucose of the experiment and control group [(6.3±0.6)mmol/L and (7.6±1.3)mmol/L]and 2 h postprandial blood glucose[(7.2±0.9)mmol/L and(9.7±1.2)mmol/L]after education were much lower than those before education(P<0.01)while the blood eontrol of the experimental group was much better.The rate of operative delivery was 58.3%,fetal macrosomia 2.7%,and fetal distress was 5.5%,and all were significantly lower than those of control group(P<0.05).Condusions Nutritional health education is the effective way for blood sugar control.Using the knowledge of GI to choose food is much easier to control blood sugar compared with food exchanging system.It can be applied widly in clinics and communities.We suggest GDM patients arrange their diets by combination of GI and food exchanging system which is more scientific and reasonable.
