Influence of Intervention through Diets and Exercises on Controlling the Blood Glucose of Patients with Gestational Diabetes Mellitus_West China Medical Journal

Authors：

 LILing-ling ¹ , YANTing ¹ , LIUJun ² ,  HEQing ¹

1. Department of Clinical Nutrition, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, P. R. China;
2. Department of Statistics, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, P. R. China;

Corresponding author：

HEQing, Email: heqingdoc@163.com

Keywords：

Diabetes mellitus; Pregnancy; Dietary guidance; Exercise therapy

DOI：

10.7507/1002-0179.20140623

Video：

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Objective To investigate the effect of behavior intervention through diets and exercises on blood glucose controlling in patients with gestational diabetes mellitus (GDM), and to provide the basis for GDM therapy. Methods A total of 116 patients with GDM diagnosed and treated in the Sixth Affiliated Hospital of Sun Yat-sen University between March 2011 and December 2012 were taken as our study objects, including 72 patients in the study group and 44 patients in the control group, based on their will. For patients in the study group, we carried out behavior interventions through diets and exercises, including dietary guidance, giving pamphlet and formulating exercise plan, while for patients in the control group, we only gave them oral guidance and publicity materials. The same questionnaire was used to collect all the patients' information. Follow-up was done once in every 3 days, and rechecking was performed 2 weeks later. The results of oral glucose tolerance test and the rate of pathoglycemia were compared in these groups before and after intervention. Results The fasting blood glucose, 1- and 2-hour blood glucose were lowered after the behavior intervention in the study group (P<0.05), which were also significantly lower than the control group (P<0.05). Fasting blood glucose, 1- and 2-hour pathoglycemia was significantly lower in the study group than that in the control group and that before intervention (P<0.05). Conclusion Combination of diets and exercises can control levels of blood glucose in GDM patients, and is an important therapy for GDM.

Citation： LILing-ling, YANTing, LIUJun, HEQing. Influence of Intervention through Diets and Exercises on Controlling the Blood Glucose of Patients with Gestational Diabetes Mellitus. West China Medical Journal, 2014, 29(11): 2069-2072. doi: 10.7507/1002-0179.20140623 Copy

1.	莫萍, 吴惠芳, 杨振玲, 等. 妊娠期糖尿病筛查450例结果分析[J]. 中国妇幼保健, 2004, 19(7):15-16.
2.	张燕军, 马文君, 肖本熙, 等. 糖代谢异常孕妇的营养状况及血糖的膳食影响因素分析[J]. 中国全科医学, 2008, 11(23):2113-2115.
3.	International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy[J]. Diabetes Care, 2010, 33(3):676-682.
4.	Zhang F, Dong L, Zhang CP, et al. Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008[J]. Diabet Med, 2011, 28(6):652-657.
5.	Chu SY, Callaghan WM, Kim SY, et al. Maternal obesity and risk of gestational diabetes mellitus[J]. Diabetes Care, 2007, 30(8):2070-2076.
6.	马冠生, 李艳平, 武阳丰, 等. 1992至2002年间中国居民超重率和肥胖率的变化[J]. 中华预防医学杂志, 2005, 39(5):17-21.
7.	Matuszek B, Burska A, Leszczyńska-Gorzelak B, et al. Comparative analysis of adiponectin isoform distribution in pregnant women with gestational diabetes mellitus and after delivery[J]. Acta Obstet Gynecol Scand, 2013, 92(8):951-959.
8.	董玉英, 孙云燕, 杨悦旻, 等. 应用胰岛素泵短期强化治疗妊娠期糖尿病疗效分析[J]. 中国实用妇科与产科杂志, 2008, 24(10):755-758.
9.	邹阮敏, 李云云, 包影, 等. 妊娠期糖尿病早期诊断及治疗对妊娠结局的影响[J]. 医学研究杂志, 2011, 40(9):84-87.
10.	Moreno-Castilla C, Hernandez M, Bergua M, et al. Low-carbohydrate diet for the treatment of gestational diabetes mellitus:a randomized controlled trial[J]. Diabetes Care, 2013, 36(8):2233-2238.
11.	潘玥, 刘巧, 朱绍密. 妊娠期糖尿病胰岛素治疗的临床分析[J]. 中国计划生育和妇产科, 2011, 3(6):57-60.
12.	Reader D, Splett P, Gunderson EP. Impact of gestational diabetes mellitus practice guidelines implemented by registered dietitians[J]. J Am Diet Assoc, 2006, 106(9):1426-1433.
13.	Louie JC, Brand-Miller JC, Carbohydrates MR, et al. Carbohydrates, glycemic index, and pregnancy outcomes in gestational diabetes[J]. Curr Diab Rep, 2013, 13(1):6-11.
14.	Zhang C, Liu S, Solomon CG, et al. Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus[J]. Diabetes Care, 2006, 29(10):2223-2230.
15.	葛茜, 林江, 张宝风, 等. 食物GI与交换份用于2型糖尿病营养治疗观察[J]. 临床和实验医学杂志, 2008, 7(12):5-6.
16.	孙建琴, 沈秀华, 宗敏, 等. 基于血糖负荷概念的食物交换份在糖尿病营养治疗中的应用[J]. 营养学报, 2006, 28(1):27-31.
17.	Zhang C, Schulze MB, Solomon CG, et al. A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus[J]. Diabetologia, 2006, 49(11):2604-2613.
18.	Afaghi A, Ghanei L, Ziaee A. Effect of low glycemic load diet with and without wheat bran on glucose control in gestational diabetes mellitus:a randomized trial[J]. Indian J Endocrinol Metab, 2013, 17(4):689-692.
19.	Barakat R, Cordero Y, Coteron J, et al. Exercise during pregnancy improves maternal glucose screen at 24-28 weeks:a randomised controlled trial[J]. Br J Sports Med, 2012, 46(9):656-661.
20.	Retnakaran R, Qi Y, Sermer M, et al. Pre-gravid physical activity and reduced risk of glucose intolerance in pregnancy:the role of insulin sensitivity[J]. Clin Endocrinol (Oxf), 2009, 70(4):615-622.
21.	杨慧霞, 徐先明, 孙伟杰. 妊娠合并糖尿病临床实践指南[M]. 北京:人民卫生出版社, 2008:189-196.

1. 莫萍, 吴惠芳, 杨振玲, 等. 妊娠期糖尿病筛查450例结果分析[J]. 中国妇幼保健, 2004, 19(7):15-16.
2. 张燕军, 马文君, 肖本熙, 等. 糖代谢异常孕妇的营养状况及血糖的膳食影响因素分析[J]. 中国全科医学, 2008, 11(23):2113-2115.
3. International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy[J]. Diabetes Care, 2010, 33(3):676-682.
4. Zhang F, Dong L, Zhang CP, et al. Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008[J]. Diabet Med, 2011, 28(6):652-657.
5. Chu SY, Callaghan WM, Kim SY, et al. Maternal obesity and risk of gestational diabetes mellitus[J]. Diabetes Care, 2007, 30(8):2070-2076.
6. 马冠生, 李艳平, 武阳丰, 等. 1992至2002年间中国居民超重率和肥胖率的变化[J]. 中华预防医学杂志, 2005, 39(5):17-21.
7. Matuszek B, Burska A, Leszczyńska-Gorzelak B, et al. Comparative analysis of adiponectin isoform distribution in pregnant women with gestational diabetes mellitus and after delivery[J]. Acta Obstet Gynecol Scand, 2013, 92(8):951-959.
8. 董玉英, 孙云燕, 杨悦旻, 等. 应用胰岛素泵短期强化治疗妊娠期糖尿病疗效分析[J]. 中国实用妇科与产科杂志, 2008, 24(10):755-758.
9. 邹阮敏, 李云云, 包影, 等. 妊娠期糖尿病早期诊断及治疗对妊娠结局的影响[J]. 医学研究杂志, 2011, 40(9):84-87.
10. Moreno-Castilla C, Hernandez M, Bergua M, et al. Low-carbohydrate diet for the treatment of gestational diabetes mellitus:a randomized controlled trial[J]. Diabetes Care, 2013, 36(8):2233-2238.
11. 潘玥, 刘巧, 朱绍密. 妊娠期糖尿病胰岛素治疗的临床分析[J]. 中国计划生育和妇产科, 2011, 3(6):57-60.
12. Reader D, Splett P, Gunderson EP. Impact of gestational diabetes mellitus practice guidelines implemented by registered dietitians[J]. J Am Diet Assoc, 2006, 106(9):1426-1433.
13. Louie JC, Brand-Miller JC, Carbohydrates MR, et al. Carbohydrates, glycemic index, and pregnancy outcomes in gestational diabetes[J]. Curr Diab Rep, 2013, 13(1):6-11.
14. Zhang C, Liu S, Solomon CG, et al. Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus[J]. Diabetes Care, 2006, 29(10):2223-2230.
15. 葛茜, 林江, 张宝风, 等. 食物GI与交换份用于2型糖尿病营养治疗观察[J]. 临床和实验医学杂志, 2008, 7(12):5-6.
16. 孙建琴, 沈秀华, 宗敏, 等. 基于血糖负荷概念的食物交换份在糖尿病营养治疗中的应用[J]. 营养学报, 2006, 28(1):27-31.
17. Zhang C, Schulze MB, Solomon CG, et al. A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus[J]. Diabetologia, 2006, 49(11):2604-2613.
18. Afaghi A, Ghanei L, Ziaee A. Effect of low glycemic load diet with and without wheat bran on glucose control in gestational diabetes mellitus:a randomized trial[J]. Indian J Endocrinol Metab, 2013, 17(4):689-692.
19. Barakat R, Cordero Y, Coteron J, et al. Exercise during pregnancy improves maternal glucose screen at 24-28 weeks:a randomised controlled trial[J]. Br J Sports Med, 2012, 46(9):656-661.
20. Retnakaran R, Qi Y, Sermer M, et al. Pre-gravid physical activity and reduced risk of glucose intolerance in pregnancy:the role of insulin sensitivity[J]. Clin Endocrinol (Oxf), 2009, 70(4):615-622.
21. 杨慧霞, 徐先明, 孙伟杰. 妊娠合并糖尿病临床实践指南[M]. 北京:人民卫生出版社, 2008:189-196.

West China Medical Journal

Influence of Intervention through Diets and Exercises on Controlling the Blood Glucose of Patients with Gestational Diabetes Mellitus

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