The predictive value of oral glucose tolerance test results on dietary control effect in pregnant women with gestational diabetes mellitus

Objective:To explore the predictive value of oral glucose tolerance test results on blood glucose control in the course of dietary control in pregnant women with gestational diabetes mellitus(GDM),analyze the improving effect of dietary therapy on outcomes of GDM.Methods:265 pregnant women with GDM were selected from department of nutrition,maternal and child health hospital of Xiamen from 2007 to 2009,571 normal pregnant women at the same time were selected as control group;general conditions including age,body weight,blood pressure,GDM screening and results of oral glucose tolerance test were recorded;and their pregnancy outcomes were followed up.Results:There was no significant difference in pregestational BMI,educational level and changes of blood pressure during pregnancy between the two groups,the age of GDM group was significantly older than that of control group(t=4.389,P0.05).The control rate of blood glucose during dietary control in GDM women with normal fasting blood glucose was significantly higher than that in GDM women with high fasting blood glucose(χ2=12.079,P0.001);among GDM women with normal fasting blood glucose,the levels of one hour postprandial blood glucose and two hours postprandial blood glucose in pregnant women with poorly controlled blood glucose were significantly higher than those in pregnant women with well controlled blood glucose(t=-5.097,P0.01;t=-2.042,P0.01);for the pregnant women with one hour postprandial blood glucose12.5 mmol/L or two hours postprandial blood glucose11.0 mmol/L,the risk of poorly controlled blood glucose increased with the increase of blood glucose,OR value was within middle range(P0.05).The incidence of abnormal birth weight of neonates in poorly controlled blood glucose group was significantly higher than those in normal control group and well controlled blood glucose group,and the incidence of premature delivery in poorly controlled blood glucose group was significantly higher than that in normal control group(P0.01);the rate of cesarean section in GDM women was significantly higher than that in normal control group(P0.01).Conclusion:Age may affect the occurrence of GDM;the pregnant women with one hour postprandial blood glucose12.5 mmol/L or two hours postprandial blood glucose11.0 mmol/L have low control rate of blood glucose,more attention should be paid to GDM women whose levels of fasting blood glucose are higher than standard;timely,effective and reasonable dietary control may control blood glucose within ideal range,which can reduce the harm of GDM to mothers and their babies.