Can a Low–Glycemic Index Diet Reduce the Need for Insulin in Gestational Diabetes Mellitus?
低血糖指数饮食能够减低胰岛素在妊娠期糖尿病中的需求吗?
低血糖指数饮食能够减低胰岛素在妊娠期糖尿病中的需求吗?
小顾营养译
In normal subjects, mixed meals based on low–glycemic index foods lead to a reduction in postprandial glycemia . We have previously demonstrated in normal pregnant women that a diet based on low–glycemic index foods was sustainable and resulted in more favorable fetal outcomes (7). The aim of this study was to examine whether a low–glycemic index diet used as MNT for women with GDM could result in a reduced need for insulin use during pregnancy with no compromise of obstetric and fetal outcomes.
在正常受试者中,主要以低糖指数食物为主的混合饮食可导致餐后血糖降低。我们先前曾在正常的孕妇身上证明低糖指数食物是可持续发挥作用并最终得到更加有利的胎儿的结果(7)。本研究的目的是探讨低糖饮食作为GDM妇女的MNT，是否能降低怀孕期间的胰岛素使用量，同时还能保证母子平安。
Abstract
Background A low glycemic index (GI) diet is effective as treatment for people with diabetes and has been shown to improve pregnancy outcomes when used from the first trimester. A low GI diet is commonly advised as treatment for women with gestational diabetes mellitus (GDM). However the efficacy and pregnancy outcomes of this advice have not been systematically examined.
摘要
背景 低血糖指数（GI）饮食是糖尿病人的有效治疗手段，并且若在初期开始用于怀孕病人，已经显示可以改善怀孕结果。低的GI饮食被普遍推荐为妊娠期糖尿病（GDM）妇女的治疗手段。然而这一建议的效果和怀孕结果并没有进行系统检验。
Objective To determine if prescribing a low glycemic index (GI) diet for women diagnosed with GDM could reduce the number of women requiring insulin without compromise of pregnancy outcomes.
目标 确定如果开一个较低的血糖指数(GI)饮食给那些被诊断为GDM的女性可以减低需要胰岛素来保证怀孕结果的女性数量
Design All women with GDM seen over a 12-month period were considered for inclusion in the study. Women (n = 63) were randomised to receive either a low GI diet or a conventional high fiber (and higher GI) diet
设计 所有在十二个月这一周期内被发现的患有GDM的女性被列入研究，这些女性(n = 63)被随机分配接受低GI饮食或一个传统的高纤维、高GI)的饮食。
Results Of the 31 women randomised to a low GI diet, 9 (29%) required insulin. Of the women randomised to a higher GI diet, a significantly higher proportion, 19/32 (59%), met the criteria to commence on insulin (p = 0.023). However 9 of these 19 women were able to avoid insulin use by changing to a low GI diet. Key obstetric and fetal outcomes were not significantly different.
结果 31名被随机分配为低GI饮食组的女性中有9人(29%)需要胰岛素。被随机分配为高GI饮食组的女性中,需要胰岛素的妇女比例明显升高,这一比例为19/32(59%),达到了开始使用胰岛素的标准(p = 0.023)。然而,这19个女人中有9个是能够通过改为低GI饮食来避免使用胰岛素的。产科和胎儿产出结果的关键并没有明显区别。
Conclusions Using a low GI diet for women diagnosed with GDM effectively halved the number needing to use insulin with no compromise of obstetric or fetal outcomes.
结论 对患有GDM的妇女，采用低GI饮食能有效使一半的患者不需要使用胰岛素就可保证母子平安
In normal subjects, mixed meals based on low–glycemic index foods lead to a reduction in postprandial glycemia . We have previously demonstrated in normal pregnant women that a diet based on low–glycemic index foods was sustainable and resulted in more favorable fetal outcomes (7). The aim of this study was to examine whether a low–glycemic index diet used as MNT for women with GDM could result in a reduced need for insulin use during pregnancy with no compromise of obstetric and fetal outcomes.
在正常受试者中,主要以低糖指数食物为主的混合饮食可导致餐后血糖降低。我们先前曾在正常的孕妇身上证明低糖指数食物是可持续发挥作用并最终得到更加有利的胎儿的结果(7)。本研究的目的是探讨低糖饮食作为GDM妇女的MNT，是否能降低怀孕期间的胰岛素使用量，同时还能保证母子平安。
Abstract
Background A low glycemic index (GI) diet is effective as treatment for people with diabetes and has been shown to improve pregnancy outcomes when used from the first trimester. A low GI diet is commonly advised as treatment for women with gestational diabetes mellitus (GDM). However the efficacy and pregnancy outcomes of this advice have not been systematically examined.
摘要
背景 低血糖指数（GI）饮食是糖尿病人的有效治疗手段，并且若在初期开始用于怀孕病人，已经显示可以改善怀孕结果。低的GI饮食被普遍推荐为妊娠期糖尿病（GDM）妇女的治疗手段。然而这一建议的效果和怀孕结果并没有进行系统检验。
Objective To determine if prescribing a low glycemic index (GI) diet for women diagnosed with GDM could reduce the number of women requiring insulin without compromise of pregnancy outcomes.
目标 确定如果开一个较低的血糖指数(GI)饮食给那些被诊断为GDM的女性可以减低需要胰岛素来保证怀孕结果的女性数量
Design All women with GDM seen over a 12-month period were considered for inclusion in the study. Women (n = 63) were randomised to receive either a low GI diet or a conventional high fiber (and higher GI) diet
设计 所有在十二个月这一周期内被发现的患有GDM的女性被列入研究，这些女性(n = 63)被随机分配接受低GI饮食或一个传统的高纤维、高GI)的饮食。
Results Of the 31 women randomised to a low GI diet, 9 (29%) required insulin. Of the women randomised to a higher GI diet, a significantly higher proportion, 19/32 (59%), met the criteria to commence on insulin (p = 0.023). However 9 of these 19 women were able to avoid insulin use by changing to a low GI diet. Key obstetric and fetal outcomes were not significantly different.
结果 31名被随机分配为低GI饮食组的女性中有9人(29%)需要胰岛素。被随机分配为高GI饮食组的女性中,需要胰岛素的妇女比例明显升高,这一比例为19/32(59%),达到了开始使用胰岛素的标准(p = 0.023)。然而,这19个女人中有9个是能够通过改为低GI饮食来避免使用胰岛素的。产科和胎儿产出结果的关键并没有明显区别。
Conclusions Using a low GI diet for women diagnosed with GDM effectively halved the number needing to use insulin with no compromise of obstetric or fetal outcomes.
结论 对患有GDM的妇女，采用低GI饮食能有效使一半的患者不需要使用胰岛素就可保证母子平安
附：
什么是血糖生成指数(GI)?
GI表示某种食物升高血糖效应与标准食品(通常为葡萄糖)升高血糖效应之比。GI值越高，说明这种食物升高血糖的效应越强。
碳水化合物含量相同的食物进入人体后，为什么会引起完全不同的血糖应答呢？这是由于不同的碳水化合物食物在肠胃内消化吸收的速度不同所致，而消化吸收的快慢又与碳水化合物本身的结构、类型有关。此外，加工方式，如颗粒大小、软硬、生熟、稀稠及时间、温度、压力等对GI都有影响。总之，越是容易消化吸收的食物，GI值越高。
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