妊娠期糖尿病患者服用糖尿病专用配方奶粉可改善餐后血糖控制并推迟胰岛素的使用：来自两个中心的随机对照试验。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2024-11-06 DOI:10.1016/j.clnu.2024.11.001

Ruihua Yang , Weiling Han , Wei Zheng , Dong Xu , Jing He , Xianxian Yuan , Li Zhang , Zhihong Tian , Guanghui Li

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引用次数: 0

摘要

背景和目的：关于糖尿病专用配方奶粉在妊娠糖尿病（GDM）中应用的研究有限，其作用尚未得到很好的研究。我们探讨了糖尿病专用配方对 GDM 患者血糖水平、胰岛素使用和妊娠结局的影响：在这项随机对照研究中，112 名 GDM 患者被随机分配到干预组（56 人）和对照组（56 人）。两组均接受个性化饮食咨询。干预组以大豆蛋白、高单不饱和脂肪酸和多种纤维的糖尿病专用配方奶代替牛奶作为早餐，并在晚餐后加餐。所有参与者每两周接受一次随访，直至分娩。结果显示，与对照组相比，干预组的血糖水平、胰岛素用量和妊娠结局均优于对照组：与对照组相比，干预组早餐后 2 小时的餐后血糖水平明显较低（5.84 ± 0.56 vs. 6.15 ± 0.44 mmol/L，p = 0.008），餐后时间在范围内的值较高（83.80 % vs. 78.95 %，p = 0.045）。干预组使用胰岛素的时间较晚（33 周 vs. 28 周，p = 0.015），使用天数较少（36 天 vs. 78 天，p = 0.024），但两组在使用胰岛素的比例、剂量或频率上没有差异。两组间的妊娠结局无明显差异：结论：糖尿病专用配方能明显降低 GDM 患者餐后血糖水平，改善餐后血糖控制。此外，它还推迟了胰岛素的使用时间，缩短了胰岛素治疗的持续时间。我们的研究结果可能为 GDM 患者实现更好的个性化血糖控制提供了一种潜在的新方法：临床试验注册号：NCT03957603（已在 ClinicalTrials.gov 注册）。

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Administration of a diabetes-specific formula can improve postprandial glycemic control and delay insulin use in gestational diabetes mellitus: A randomized controlled trial from two centers

Background and aims

There have been limited studies on the application of a diabetes-specific formula in gestational diabetes mellitus (GDM), the role of which has not been well studied. We explored the effect of a diabetes-specific formula on blood glucose levels, insulin use and pregnancy outcomes in GDM patients.

Methods

In this randomized controlled study, 112 GDM patients were randomly assigned to the intervention group (56) and the control group (56). Both groups received individualized dietary counseling. The intervention group consumed a soy-protein-based, high-monounsaturated-fatty-acid, and multi-fiber diabetes-specific formula as milk replacement for breakfast and an extra meal after dinner. All participants were followed up every two weeks until delivery. The blood glucose levels, insulin use and pregnancy outcomes between the groups were compared.

Results

Compared to the control group, the intervention group had significantly lower 2h postprandial blood glucose levels after breakfast (5.84 ± 0.56 vs. 6.15 ± 0.44 mmol/L, p = 0.008), and exhibited higher postprandial time in range values (83.80 % vs. 78.95 %, p = 0.045). The intervention group used insulin later (33 vs. 28 weeks, p = 0.015) and for fewer days (36 vs 78 days, p = 0.024), but no differences in the proportion, dose or frequency of insulin use between the groups. There were no significant differences in pregnancy outcomes between the groups.

Conclusions

The diabetes-specific formula significantly decreased postprandial blood glucose levels and improved postprandial glycemic control in GDM patients. Moreover, it delayed the initiation of insulin use and reduced the duration of insulin therapy. Our findings may offer a potential new approach for achieving better personalized blood glucose control in GDM patients.

Registration number of clinical trial

NCT03957603 (registered at ClinicalTrials.gov).

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.