扫描式葡萄糖监测联合个体化医学营养对妊娠糖尿病患者糖脂代谢的影响  

Effects of Flash Glucose Monitoring Combined with Individualized Medical Nutrition on Glucose and Lipid Metabolism in Patients with Gestational Diabetes Mellitus

作　　者：刘瑞芳 唐晓红 石章海 LIU Ruifang;TANG Xiaohong;SHI Zhanghai(Maternity Health Department/Maternal Health Clinic,Maternal and Child Health Hospital of Lushan County,Pingdingshan 467300,China;Outpatient Department/General Department,Maternal and Child Health Hospital of Lushan County,Pingdingshan 467300,China;Ministry of Health Care/Physical Examination Center,Pingdingshan Maternal and Child Health Hospital,Pingdingshan 467000,China)

机构地区：[1]鲁山县妇幼保健院孕产保健部/孕产期保健门诊,河南平顶山467300 [2]鲁山县妇幼保健院门诊部/综合科,河南平顶山467300 [3]平顶山市妇幼保健院保健部/体检中心,河南平顶山467000

出　　处：《河南医学研究》2022年第12期2216-2219,共4页Henan Medical Research

摘　　要：目的研究个体化医学营养与扫描式葡萄糖监测(FGM)联合对妊娠糖尿病(GDM)患者糖脂代谢的影响。方法选取2019年5月至2020年5月鲁山县妇幼保健院收治的94例GDM患者。采用随机数表法将患者分为对照组和研究组,每组47例。给予对照组患者常规血糖监测及饮食指导,给予研究组患者FGM联合个体化医学营养。比较两组干预前、入院待产时糖化血红蛋白(HbAlc)、餐后2 h血糖(2 h FBG)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、稳态模型评估的胰岛β细胞功能指数(HOMA-β)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)。随访至妊娠结束,比较两组妊娠结局。结果入院待产时,两组HbAlc、FPG、2 h FBG、TC、TG水平均降低,研究组HbAlc、FPG、2 h FBG、TC、TG水平较对照组低(P<0.05)。入院待产时,两组HOMA-β升高,研究组HOMA-β高于对照组(P<0.05);入院待产时,两组HOMA-IR均降低,研究组HOMA-IR低于对照组(P<0.05)。研究组胎儿宫内窘迫、早产、新生儿窒息、巨大儿、新生儿低血糖的发生率均较对照组低(P<0.05)。结论FGM联合个体化医学营养能进一步改善GDM患者的糖脂代谢情况和胰岛功能指标,从而改善妊娠结局。Objective To study the effect of individualized medical nutrition combined with flash glucose monitoring(FGM)on glucose and lipid metabolism in patients with gestational diabetes mellitus(GDM).Methods From May 2019 to May 2020,94 patients with GDM in Maternal and Child Health Hospital of Lushan County were selected.According to the method of random number table,the patients were divided into control group and study group,with 47 cases in each group.The patients in control group were given routine blood glucose monitoring and dietary guidance,while the patients in study group were given FGM combined with individualized medical nutrition.The glycosylated hemoglobin(HbAlc),2-hour postprandial blood glucosepostprandial blood glucose(2 h FBG),fasting plasma glucose(FPG),triglyceride(TG),total cholesterol(TC),homestasis model assessment for islet β cell function index(HOMA-β)and homestasis model assessment for insulin resistance(HOMA-IR)were compared between the two groups before and after intervention.Follow-up to the end of pregnancy,and the pregnancy outcomes of the two groups were compared.Results The levels of HbAlc,FPG,2 h FBG,TC and TG in the two groups decreased when they were admitted to hospital for labor,and the levels of HbAlc,FPG,2 h FBG,TC and TG in study group were lower than those in control group(P<0.05).At the time of delivery,HOMA-β in the two groups increased,and HOMA-β in study group was higher than that in control group(P<0.05).HOMA-IR in both groups decreased when they were admitted to hospital,and HOMA-IR in study group was lower than that in control group(P<0.05).The incidences of fetal distress,premature delivery,neonatal asphyxia,macrosomia and neonatal hypoglycemia in study group were lower than those in control group(P<0.05).Conclusion FGM combined with individualized medical nutrition can further improve the glucose and lipid metabolism and islet function indexes of GDM patients,thus improving the pregnancy outcome.

关 键 词：妊娠糖尿病 扫描式葡萄糖监测 个体化医学营养 糖脂代谢 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]