妊娠糖尿病患者的膳食结构及基于膳食调查的个性化营养干预对患者血糖和体重增长速率的影响  

Dietary pattern and effects of individualized nutritional intervention based on dietary survey on blood glucose and weight gain rate in patients with gestational diabetes mellitus

作　　者：顾然[1,2] 洪晶安 朱佳妮[1,2] 张伦 杨帆 张振宇 GU Ran;HONG Jing-an;ZHU Jia-ni;ZHANG Lun;YANG Fan;ZHANG Zhen-yu(Department of Clinical Nutriology,the First People′s Hospital of Yunnan Province;Department of Nutriology,the Affiliated Hospital of Kunming University of Science and Technology,Kunming 650032,China)

机构地区：[1]云南省第一人民医院临床营养科 [2]昆明理工大学附属医院营养科,昆明市650032

出　　处：《广西医学》2021年第3期309-312,321,共5页Guangxi Medical Journal

摘　　要：目的调查妊娠糖尿病(GDM)患者的膳食结构,并分析基于膳食调查的个性化营养干预对患者血糖及体重增长速率的影响。方法选取98例GDM的单胎孕妇为研究对象,调查患者近3 d的膳食状况、孕中期体重增长情况,根据调查结果进行个性化营养干预。比较干预前后空腹血糖、餐后2 h血糖、体重增长速率的变化。结果(1)干预前,GDM患者蛋白质、脂肪、膳食纤维、维生素A、维生素D、维生素B_(1)、维生素B_(2)、维生素B_(6)、叶酸、钙、钠、镁、铁实际摄入量低于推荐摄入量,而能量、碳水化合物、维生素E、烟酸、磷、锌、铜实际摄入量高于推荐摄入量;谷薯类及杂豆类、畜禽肉类、油脂类、盐实际摄入量高于参考摄入量,而蔬菜类、鱼虾类、奶类及奶制品、大豆及坚果类实际摄入量低于参考摄入量;蛋白质供能比低于推荐范围,脂肪供能比高于推荐范围。(2)干预后,GDM患者空腹血糖和餐后2 h血糖低于干预前,体重增长速率优于干预前(均P<0.05)。结论GDM患者膳食结构不合理,基于膳食调查的个性化营养干预对于GDM患者孕期的体重适度增长及血糖控制具有重要意义。Objective To investigate the dietary pattern of patients with gestational diabetes mellitus(GDM),and to analyze the effects of individualized nutritional intervention based on a dietary survey on patients′blood glucose and weight gain rate.Methods A total of 98 singleton pregnant women with GDM were selected as subjects,and a survey was performed on their dietary status in three days and weight gain in the second trimester.Individualized nutritional intervention was conducted based on the survey results.Changes in FBG,2-hour postprandial blood glucose and weight gain rate before and after intervention were compared.Results(1)Before intervention,the actual intakes of protein,fat,dietary fiber,vitamin A,vitamin D,vitamin B_(1),vitamin B_(2),vitamin B_(6),folic acid,calcium,sodium,magnesium and iron were lower than the recommended intakes,while the actual intakes of energy,carbohydrate,vitamin E,niacin,phosphorus,zinc and copper were higher than the recommended intakes;the actual intakes of corn and potato,miscellaneous bean,poultry and meat,oil-bearing crop and salt were higher than the reference intakes,whereas the actual intakes of vegetables,fish and shrimp,milk and dairy products,soy and nuts were below than the reference intakes;the protein-energy ratio was lower and the fat-energy ratio was higher than the recommended ranges.(2)After intervention,the levels of FBG and 2-hour postprandial blood glucose were lower and the weight gain rate was superior in GDM patients than those before intervention(all P<0.05).Conclusion GDM patients have unreasonable dietary structure.Individualized nutritional intervention based on a dietary survey possesses important implications in the moderate weight growth and blood glucose control among GDM patients during pregnancy.

关 键 词：妊娠糖尿病 个性化营养干预 膳食调查 膳食结构 血糖 体重增长 

分 类 号：R714.25[医药卫生—妇产科学]