The role of dietotherapy in prevention of a diabetic fetopathy at women with gestational diabetes mellitus

Abstract

The Gestational Diabetes Mellitus (GDM) is the disease, being characterized a hyperglycemia for the first time revealed during pregnancy. The main method of GDM treatment is diet. During our research we compared efficiency of different recommendations about a diet therapy in prevention of macrosomia, the birth with large gestation age (LGA) and other diabetic fetopathy (DF) manifestations. Our results showed that a diet with a low and medium glycemic index of products, a fractional food taking into account physiological secretion of insulin and insulinoresistance during pregnancy allows to achieve a target values of glucose from pregnant women with GDM, decrease the frequency of purpose of insulin therapy because of pre-natal manifestations of DF, decrease the risk of macrosomia development and frequency of cesarean section in connection with the LGA a fetus.

Keywords

pregnancy / gestational diabetes mellitus / dietotherapy / products with a low and medium glycemic index / macrosomia / diabetic fetopathy

References

[1] Арбатская Н., Харебова-Швец В. Как родить здорового ребенка, если у тебя сахарный диабет. — М.: Эксмо, 2009. — 256 с.

[2] Арбатская Н. Ю. Тактика диагностики и лечения нарушения углеводного обмена во время беременности // Доктор. Ру. — 2008. — № 6. — С. 81–86.

[3] Арбатская Н. Ю., Демидова И. Ю., Рагозин А. К. Дневник по сахарному диабету и беременности. — М.: СофтИздат, 2010. — 102 с.

[4] Дедов И. И., Краснопольский В. И., Сухих Г. Т. От имени рабочей группы Российский национальный консенсус «Гестационный сахарный диабет: диагностика, лечение, послеродовое наблюдение» // Сахарный диабет. — 2012. — № 4. — С. 4–10.

[5] Дедов И. И., Шестакова М. В. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. — М., 2011.

[6] Краснопольский В. И., Петрухин В. А., Бурумкулова Ф. Ф. Гестационный сахарный диабет — новый взгляд на старую проблему // Акушерство и гинекология. — 2010. — № 2. — С. 3–6.

[7] Распространенность нарушений углеводного обмена у женщин Крайнего Севера в период гестации / Сметанина С. А., Суплотова Л. А., Бельчикова Л. Н., Новаковская Н. А. // Материалы V Всероссийского диабетологического конгресса. — М., 2010. — С. 462.

[8] A multicenter, randomized trial of treatment fr mild gestational diabetes / Landon M. B., Spng C. Y., Thom E. [et al.] // New England Journal of Medicine. — 2009. — Vol. 361, N 14. — P. 1339–1348.

[9] Alberti K. G., Zimmet P. Z. Definition, diagnosis and classification of diabetes mellitus and its complications // Diab. Med. — 1998. — Vol. 15. — P. 539–553.

[10] Can a low-glycemic index diet reduce the need for insulin in gestational diabetes mellitus? / Moses R. G., Barker M., Winter M. [et al.] // Diabetes Care. — 2009. — Vol. 32, N 6. — P. 996–1000.

[11] Childhood obesity and metabolic imprinting: the ongoing effect of maternal hyperglycemia / Hiller T. A., Pedula K. L., Schmind M. M. [et al.] // Diabetes Care. — 2007. — Vol. 30, N 9. — P. 2287–2292.

[12] Dietary fiber intake, dietary glicemic load, and the risk for gestational diabetes mellitus / Zhang C., Liu S., Solomon C. G., Hu F. B. // Diabetes Care. — 2006. — Vol. 29. — P. 2223–2230.

[13] Effect of a low-glycemic-index diet during pregnancy on obstetric outcomes / Moses R. G., Luebcke M., Davis W. S. [et al.] // Am. J. Clin. Nutrition. — 2006. — Vol. 84. — P. 807–812.

[14] Effect of treatment of gestational diabetes mellitus on pregnancy outcomes / Crowther C. A., Hiller J. E., Moss J. R. [et al.] // N. Engl. J. Med. — 2005. — Vol. 352, N 24. — P. 2477–2486.

[15] Galgani J., Aguirre C., Dнaz E. Acute effect of meal glycemic index and glycemic load on blood glucose and insulin responses in humans // Nutr. J. — 2006. — Vol. 5. — P. 22.

[16] Glycemic indices and pregnancy: a systematic literature review / Louie J. C., Bar-Eyal A., Voet H., Madar Z. // J. Nutr. Metab. — 2010. URL: http://www.hindawi.com/ journals/jnume/2010/282464 / (дата обращения 17.04.2013).

[17] Hod M., Carrapato M. Diabetes and pregnancy evidence based update and guidelines / Working group on Diabetes and pregnancy. — Prague, 2006.

[18] Kopp W. Role of high-insulinogenic nutrition in the etiology of gestational diabetes mellitus // Med. Hypotheses. — 2005. — Vol. 64. — P. 101–103.

[19] Kramer M. S., Kakuma R. Energy and protein intake in pregnancy // Cochrane Database of systematic reviews. — 2008. — Vol. 31, N 1.

[20] Magee M. S., Knopp R. H., Benedetti T. J. Metabolic effects of 1200-kcal diet in obese pregnant women with gestational diabetes // Diabetes. — 1990. — Vol. 39. — P. 234–240.

[21] Medical nutrition therapy evidence- based guides for practice: nutrition practice guidelines type 1 and type 2 diabetes mellitus / American Diabetes Association. — Chicago, 2001.

[22] Metabolik syndrm in bes children brn large for gestaional age / Wang X., Liang L., Jufen F. U., Lizhong D. U. //Indian J. Pediatr. — 2007. — Vol. 74. — P. 561–565.

[23] Peterson C. M., Jovanovik-Peterson L. Percentage of carbohydrate and glycemic response to breakfast, lunch, and dinner in women with gestational diabetes // Diabetes. — 1991. — Vol. 40. — P. 172–174.

[24] Position statement: diagnosis and classi cation of diabetes mellitus / American Diabetes Association // Diabetes Care. — 2010. — Vol. 33, suppl. — P. 62–69.

[25] Pregestational diabetes mellitus Practice bulletin / American College of Obstetricians and Gynecologist. N 60 // Obstet. Gynecol. — 2005. — Vol. 105. — P. 675–685.

[26] Relations of glycemic index and glycemic load with plasma oxidative stress markers / Hu Y., Block G., Norkus E. P. [et al.] // Am. J. Clin. Nutrition. — 2006. — Vol. 84, N 1. — P. 70–76.

[27] Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus // Diabetes Care. — 2007. — Vol. 30, suppl. 2. — P. 251–260.

[28] The effects of carbohydrate restriction in patients with diet-controlled gestational diabetes / Major C. A., Henry M. J., De Venciana M., Morgan M. A. // Obstet. Gynecol. — 1998. — Vol. 91. — P. 600–604.

RIGHTS & PERMISSIONS

Arbatskaya N.Y., Ignatova N.G., Moldovanova M.V., Melnikova E.P., Kandalina V.V.