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| Effects of the goal-directed health promotion combined with the personalized medical nutrition therapy for pregnant women with gestational diabetes mellitus on their postnatal glucose-lipid metabolism prognosis |
| Xiaolan People's Hospital of Zhongshan (The Fifth People's Hospital of Zhongshan), Zhongshan, Guangdong Province, 644600 |
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Abstract To observe the effects of the goal-directed health promotion combined with the personalized medical nutrition therapy for pregnant women with gestational diabetes mellitus (GDM) on the postnatal glucose-lipid metabolism prognosis. Methods: 60 pregnant women with GDM were given the goal-oriented health education combined with the personalized medical nutrition therapy intervention were selected in the study group, and another 60 pregnant women with GDM were given the conventional health education combined with the personalized medical nutrition therapy intervention were selected in the control group from February 2021 to May 2023. The scores of the behavioral change of the women in the two groups before and after intervention were assessed. The total incidence of the adverse pregnancy outcomes of the women in the two groups was counted. The levels of the glucose and lipid metabolism and the pancreatic islet function of the women in the two groups before intervention and in the postpartum 12th weeks were detected. Results: After intervention, the scores of the self-weight management, the diet control and the moderate exercise of the women in the two groups had increased significantly, and which of the women in the study group were significantly higher than those of the women in the control group. The total incidence of the adverse pregnancy outcomes (3.3%) of the women in the study group was significantly lower than that (13.3%) of the women in the control group (all P<0.05). In the postpartum 12th week, the levels of the fasting blood glucose and the 1h and 2h postprandial blood glucose, and the glycosylated hemoglobin value of the women in the two groups had decreased significantly, and which (5.01±0.44 mmol/L, 7.20±0.51 mmol/L, 6.67±0.43 mmol/L and 5.64%±0.59%) of the women in the study group were significantly lower than those (5.54±0.63 mmol/L, 7.94±0.69 mmol/L, 7.38±0.51 mmol/L and 6.27%±0.74%) of the women in the control group. The high-density lipoprotein cholesterol and the pancreatic islet β-cell function index of the women in the two groups had increased significantly, and which (1.64±0.28 mmol/L and 64.01±7.73) of the women in the study group were significantly lower than those (1.39±0.26 mmol/L and 56.85±6.84) of the women in the control group. The levels of triglyceride (TG) and total cholesterol (TC), the value of homeostasis model assessment of insulin resistance (HOMA-IR), and the low-density lipoprotein cholesterol (LDL-C) of the women in the two groups had decreased significantly, and which (1.15±0.22 mmol/L, 4.35±0.58 mmol/L, 2.18±0.32 and 2.98±0.72 mmol/L) of the women in the study group were significantly lower than those (1.49±0.31 mmol/L, 4.63±0.67 mmol/L, 2.64±0.37 and 3.34±0.81 mmol/L) of the women in the control group (all P<0.05). Conclusion: The goal-directed health promotion combined with the personalized medical nutrition therapy for the pregnant women with GDM can promote their behavioral changes, can reduce their incidence of the adverse pregnancy outcomes, and can improve their postpartum glucolipid metabolism and pancreatic islet function.
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