The effects of carbohydrate restriction in patients with diet-controlled gestational diabetes
The effects of carbohydrate restriction in patients with diet-controlled gestational diabetes
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DOI：
10.1016/s0029-7844(98)00003-9
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发表时间：
1998-04-01
影响因子：
7.2
通讯作者：
Morgan, MA
中科院分区：
文献类型：
--
作者：
Major, CA;Henry, MJ;Morgan, MA
目的：目的探讨饮食控制的妊娠期糖尿病（GDM）患者限制碳水化合物摄入对围生儿结局的影响。方法：将饮食控制的GDM患者按饮食碳水化合物含量非随机分为低碳水化合物组（低于42%）和高碳水化合物组（高于45%）。受试者保持饮食帐户，并遵循每日空腹和餐后血糖评估。受试者还每天检测尿酮。糖化血红蛋白，平均空腹和餐后血糖值，巨大儿和大于胎龄儿（LGA）的婴儿，头盆不称和巨大儿的剖宫产率，以及胰岛素治疗的需要进行了比较groups.Results：两组的人口统计学特征是相同的。低碳水化合物组受试者的餐后血糖值显著降低（P <0.04）。低碳水化合物组中需要添加胰岛素控制血糖的受试者较少（P <0.047;相对危险度[RR] 0.14; 95%置信区间[CI] 0.02，1.00）。低碳水化合物组LGA婴儿的发生率显著较低（P <0.035; RR 0.22; 95% CI 0.05，0.91）。低碳水化合物组的受试者因头盆不称和巨大儿而进行剖腹产的比率也较低（P <0.037; RR 0.15; 95% CI 0.04，0.94）。饮食控制型GDM患者的碳水化合物限制可改善血糖控制，减少胰岛素治疗的需要，降低LGA婴儿的发病率，头盆不称和巨大儿的剖宫产率也有所下降。(C)1998年由美国妇产科医师学会。
Objective: To determine the effect of carbohydrate restriction on perinatal outcome in patients with diet-controlled gestational diabetes mellitus (GDM).Methods: Women with diet-controlled GDM were divided non-randomly into two groups based on their dietary carbohydrate content: those with low dietary carbohydrate content (below 42%) and those with high dietary carbohydrate content (exceeding 45%). Subjects kept dietary accounts and were followed with daily fasting and postprandial glucose assessments. Subjects also were tested daily for urinary ketones. Glycosylated hemoglobin, mean fasting and postprandial glucose values, incidence of macrosomia and large for gestational age (LGA) infants, cesarean deliveries for cephalopelvic disproportion and macrosomia, and need for insulin therapy were compared between the groups.Results: The two groups were identical in terms of demographic characteristics. Significant reductions in the postprandial glucose values were seen among subjects in the low-carbohydrate group (P < .04). Fewer subjects in the low-carbohydrate group required the addition of insulin for glucose control (P < .047; relative risk [RR] 0.14; 95% confidence interval [CI] 0.02, 1.00). The incidence of LGA infants was significantly lower in the low-carbohydrate group (P < .035; RR 0.22; 95% CI 0.05, 0.91). Subjects in the low carbohydrate group also had a lower rate of cesarean deliveries for cephalopelvic disproportion and macrosomia (P < .037; RR 0.15; 95% CI 0.04, 0.94).Conclusion: Carbohydrate restriction in patients with diet-controlled GDM results in improved glycemic control, less need for insulin therapy, a decrease in the incidence LGA infants, and a decrease in cesarean deliveries for cephalopelvic disproportion and macrosomia. (C) 1998 by The American College of Obstetricians and Gynecologists.