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目的:研究碳水化合物计数法饮食指导对妊娠期糖尿病患者血糖的影响。方法:收集2014年10月至2015年11月本院内分泌科就诊的妊娠糖尿病患者,按随机表顺序分为试验组(n=14)和对照组(n=14)。试验组采用碳水化合物计数法饮食指导,对照组采用食物交换份法饮食指导。比较2组患者在入组后1、3个月空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2h PBG)、糖化血红蛋白(glycosylated hemoglobin,Hb A1c)、每日胰岛素用量、每日运动时间及次数的变化。结果:(1)入组1个月后,试验组患者2h PBG下降更明显,为(7.01±0.39)mmol/L(P=0.009)。(2)入组3个月后,试验组患者FBG、2h PBG明显降低,分别为(6.81±0.59)mmol/L(P=0.000)、(7.66±0.76)mmol/L(P=0.000)。(3)入组后1、3个月,试验组患者每日运动时间(P=0.010)及次数(P=0.023)均明显高于对照组。结论:碳水化合物计数法有助于妊娠糖尿病患者制定饮食、运动计划,在饮食、运动双重作用下,有效降低血糖。
Objective: To study the effects of dietary guidance of carbohydrate counting on blood glucose in gestational diabetes mellitus patients. Methods: Patients with gestational diabetes who were admitted to Department of Endocrinology from October 2014 to November 2015 were randomly divided into experimental group (n = 14) and control group (n = 14). The experimental group used the carbohydrate counting method to guide the diet, and the control group used the food exchange method to guide the diet. The fasting blood glucose (FBG), 2h postprandial blood glucose (2h PBG), glycosylated hemoglobin (Hb A1c) Daily insulin dosage, daily exercise time and the number of changes. Results: (1) After 1 month of enrollment, PBG decreased more significantly at 2h in test group (7.01 ± 0.39) mmol / L (P = 0.009). (2) After 3 months, the FBG and 2h PBG in the test group decreased significantly (6.81 ± 0.59 mmol / L, P = 0.000 and 7.66 ± 0.76 mmol / L, P = 0.000). (3) At 1 month and 3 months after operation, the daily exercise time (P = 0.010) and the number of times (P = 0.023) in the test group were significantly higher than those in the control group. Conclusion: The carbohydrate counting method helps to make diet and exercise plans for patients with gestational diabetes, and effectively reduces blood sugar under the dual action of diet and exercise.