Validation of the clinical efficacy of one-day outpatient management of patients with gestational diabetes mellitus.

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Jingwen Xu, Qian Jing, Huixia Shi, Hui Qian, Li Shi
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引用次数: 0

Abstract

Objective: A comprehensive management model called the one-day care clinic has been established and implemented throughout the hospitals as well as maternal and child health care centers for gestational diabetes mellitus (GDM) in China. However, there is still a lack of high-level evidence for this management model. The objective of this study was to describe the one-day outpatient management model and assess its efficacy in managing GDM.

Methods: A retrospective review was performed on patients who were admitted to the obstetrics clinic and diagnosed as GDM at our centers from July 2017 to June 2022. All enrolled patients were divided into two groups: the experimental group that participated in the one-day outpatient management and the control group that only received routine education on gestational diabetes in the outpatient department. Baseline characteristics and clinical data of enrolled patients were reviewed. Blood glucose level before and after attending one-day outpatient management, blood glucose and HbA1c before delivery, weight gain at the end of pregnancy, complications during pregnancy and pregnancy outcomes were collected.

Results: A total of 546 patients were finally included in this study, with 276 in the experimental group and 270 in the control group. There were no significant differences between the two groups in terms of baseline characteristics. The 1h postprandial blood glucose (PBG) and 2h PBG levels were significantly lower after participating in the one-day outpatient management compared to before (all p value < 0.01). Before delivery, the FBG, 2hPBG, and HbA1c levels in the experimental group were significantly lower than those in the control group (all p value < 0.01). The experimental group experienced less weight gain and had a higher rate of achieving weight gain goals compared to the control group. In terms of complications during pregnancy, the incidence of premature rupture of fetal membranes, pregnancy induced hypertension, and hydramnion did not differ significantly between the two groups. In terms of pregnancy outcomes, the incidence of macrosomia and neonatal hypoglycemia in the experimental group was significantly lower than in the control group (all p value < 0.05).

Conclusion: The adoption of the one-day outpatient management is more beneficial for controlling blood glucose levels and weight target during pregnancy in GDM patients. Additionally, this management can decrease the occurrence of adverse pregnancy outcomes, and improve the prognosis of both GDM patients and offspring.

妊娠期糖尿病患者一日门诊管理的临床疗效验证。
目的:在中国的医院和妇幼保健中心建立并实施了一种针对妊娠期糖尿病(GDM)的日间护理综合管理模式。然而,这种管理模式仍然缺乏高层次的证据。本研究的目的是描述一天门诊管理模式,并评估其管理GDM的功效。方法:回顾性分析2017年7月至2022年6月在我中心产科门诊就诊并诊断为GDM的患者。所有入组患者分为两组:实验组参加一日门诊管理,对照组仅在门诊接受妊娠糖尿病常规教育。回顾入组患者的基线特征和临床资料。收集患者门诊1天管理前后血糖水平、分娩前血糖及糖化血红蛋白、妊娠末体重增加、妊娠期并发症及妊娠结局。结果:最终纳入546例患者,实验组276例,对照组270例。两组在基线特征方面无显著差异。参与1天门诊管理后,餐后1h血糖(PBG)和2h血糖水平均显著低于接受门诊管理前(p值均< 0.01)。分娩前,实验组FBG、2hPBG、HbA1c水平均显著低于对照组(p值均< 0.01)。与对照组相比,实验组的体重增加较少,实现增重目标的比率更高。妊娠期并发症方面,两组胎膜早破、妊高征、羊水发生率无明显差异。在妊娠结局方面,实验组巨大儿和新生儿低血糖发生率均显著低于对照组(p值均< 0.05)。结论:采用门诊一日管理更有利于控制妊娠期GDM患者的血糖水平和体重指标。此外,这种管理可以减少不良妊娠结局的发生,改善GDM患者和后代的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
217
审稿时长
2-3 weeks
期刊介绍: The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.
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