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目的:采用连续动态血糖监测(CGMS)评估妊娠期糖尿病(GDM)营养运动治疗后效果。方法:对150例GDM孕妇经3~5天饮食和运动指导治疗后,采用CGMS进行72 h血糖监测。结果:餐前血糖平均值、餐后血糖平均值与葡萄糖耐量试验(OGTT)时的空腹和餐后血糖相比,均有明显下降,餐后血糖的平均值的下降有统计学意义(P<0.05)。按照体重指数(BMI)将孕妇分成正常组和超重组,超重组24 h内平均血糖值均高于正常组血糖值,孕妇血糖水平呈波动性变化。三餐后0~120 min血糖的平均值与晨起指尖毛细血管血糖值比较,差异有统计学意义(P<0.05)。71.0%孕妇空腹或餐前血糖值小于3.9 mmol/L,其中32.3%小于3.3 mmol/L。结论:连续动态监测妊娠期糖尿病孕妇血糖,使临床医生更加便捷地评估和调整治疗方案,可以诊断妊娠期妇女餐后所遗漏的高血糖和夜间无症状低血糖事件,是现在常用的自我血糖监测方法,建议在临床上对孕妇间断应用CGMS作为控制调节血糖。
OBJECTIVE: To evaluate the effect of gestational diabetes mellitus (GDM) nutrition exercise by continuous dynamic glucose monitoring (CGMS). Methods: 150 pregnant women with GDM were treated with CGMS for 72 h after 3 ~ 5 days’ diet and exercise instruction. Results: The average value of premeal blood glucose and postprandial blood glucose decreased significantly compared with fasting and postprandial blood glucose at glucose tolerance test (OGTT), and the mean decrease of postprandial blood glucose was statistically significant (P < 0.05). Pregnant women were divided into normal group and overweight group according to body mass index (BMI). The mean blood glucose level in 24 h in overweight group was higher than that in normal group, and the level of blood glucose in pregnant women was fluctuating. The average value of blood glucose at 0 ~ 120 minutes after three meals was significantly different from that at morning (P <0.05). 71.0% of pregnant women had fasting or pre-prandial glucose values less than 3.9 mmol / L, of which 32.3% were less than 3.3 mmol / L. CONCLUSIONS: Continuous and dynamic monitoring of blood glucose in pregnant women with gestational diabetes mellitus makes it easier for clinicians to evaluate and adjust the treatment regimen to diagnose post-prandial hyperglycemia and nocturnal asymptomatic hypoglycemia in pregnant women. It is now commonly used in self-monitoring of blood glucose Methods, it is recommended in the clinical intermittent use of CGMS pregnant women as a control of blood sugar.