PERCENTAGE OF CARBOHYDRATE AND GLYCEMIC RESPONSE TO BREAKFAST, LUNCH, AND DINNER IN WOMEN WITH GESTATIONAL DIABETES
PERCENTAGE OF CARBOHYDRATE AND GLYCEMIC RESPONSE TO BREAKFAST, LUNCH, AND DINNER IN WOMEN WITH GESTATIONAL DIABETES
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DOI：
10.2337/diab.40.2.s172
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发表时间：
1991-12-01
期刊：
影响因子：
7.7
通讯作者：
JOVANOVICPETERSON, L
中科院分区：
文献类型：
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作者：
PETERSON, CM;JOVANOVICPETERSON, L
我们研究了14名不需要胰岛素治疗且孕周在32至36周之间的妊娠期糖尿病妇女的1-h血糖反应与给定膳食中碳水化合物百分比的关系。每个受试者都是130%的理想体重，并被安排在24千卡·公斤-1.24小时-1的饮食中，早餐12.5%的卡路里，午餐和晚餐28%的卡路里，其他卡路里的摄入量在三种零食中分配。在每餐开始后1h通过自我血糖监测监测血糖反应。这14名女性每人每餐的平均餐后价值为10。碳水化合物百分比与餐后1h血糖水平的相关性以晚餐最强(r=0.95P<；0.001)，早餐(r=0.75，P=0.002)和午餐(r=0.86，P=0.001)的变异性较大。要维持餐后1小时的全血血糖水平，每顿饭需要摄入以下百分比的碳水化合物：早餐45%，午餐55%，晚餐50%。如果餐后1小时的全血血糖水平保持在6.67 mM，则分别为33%、45%和40%。我们得出结论，妊娠期糖尿病患者对混合膳食的血糖反应与摄入膳食中碳水化合物的百分比高度相关，并因个体以及早餐、午餐和晚餐的不同而不同。这些结果强调了死记硬背地规定怀孕期间碳水化合物含量相对较高的饮食可能会导致妊娠期糖尿病，并需要通过血糖监测来验证饮食处方的有效性。
We studied the relationship between 1-h glucose response and the percentage of carbohydrates in a given meal in 14 gestational diabetic women who did not require insulin therapy and were between 32 and 36 wk gestation. Each subject was > 130% ideal body weight and was placed on a diet of 24 kcal.kg-1.24 h-1, with 12.5% of calories at breakfast and 28% of the calories at lunch and again at dinner, with other calorie intake divided among three snacks. Glycemic response was monitored by self-monitoring of blood glucose 1 h after the start of each meal. Ten postprandial values for each meal were averaged for each of the 14 women. The correlation between percentage of carbohydrates and postprandial glucose level at 1 h was strongest for dinner (r = 0.95, P < 0.001), with more variability seen at breakfast (r = 0.75, P = 0.002) and lunch (r = 0.86, P = 0.001). To maintain a 1-h postprandial whole-blood glucose level < 7.78 mM required the following percentages of carbohydrates in each meal: 45% at breakfast, 55% at lunch, and 50% at dinner. If 1-h postprandial whole-blood glucose level was to remain < 6.67 mM, then the respective values were 33, 45, and 40%. We conclude that the glycemic response to a mixed meal in subjects with gestational diabetes is highly correlated with the percentage of carbohydrates of the ingested meal and varies among individuals and among breakfast, lunch, and dinner. These results emphasize the potential hazard of rote prescription of diets relatively high in carbohydrates during pregnancy complicated by gestational diabetes and the need to validate diet prescriptions with blood glucose monitoring.