![]() ![]() Subject exclusion criteria: (1) continuously positive for urine ketone bodies (2) fasting blood glucose and postprandial blood glucose remaining high after 1–2 weeks of nutritional intervention. Subject inclusion criteria: (1) definite diagnosis of GDM at our hospital's outpatient clinic (2) voluntarily signed the informed consent form (3) deemed suitable for treatment by a dietitian. We collected 80 patients, 26–38 years old who received a definite diagnosis of GDM at our hospital's obstetrics and gynecology outpatient clinic from November 2013 to May 2014. To test this hypothesis, we performed a controlled clinical study which aimed to explore the potential effects on blood glucose levels and pregnancy outcomes in women diagnosed with GDM for the first time. Based on this study and previous studies of the macro-nutrient preload method, we hypothesized that the nutritional composition used in the above mentioned T2DM study (Inzone Preload – a macro-nutrient blend with low-GI and low calorie content) would reduce postprandial glycemia in GDM patients when compared to controls consisting of a regular milk powder. ![]() The mode of action of macronutrient preloads is assumed to be increased satiety, reduced gastric emptying and attenuated postprandial blood sugar response. The tested macro nutrient preload was a blend of three different protein sources, slow-release carbohydrates, dietary fibres, omega3/6 fatty acids and other components. In a recent study of patients with Type 2 Diabetes (T2DM) the ingestion of a macro nutrient preload before major meals, significantly reduced 2h-PBG, HbA1c, total cholesterol/LDL and CRP at the end of a 12-week treatment period. By administration of a small load of macro-nutrients at a fixed interval before a meal (30 minutes in the majority of studies) the presence of nutrients in the small intestine induces the release of gut peptides like GLP-1, which slows gastric emptying and improves the glycemic response to the subsequent meal,. Ī new method has emerged that meet these requirements, the so called macro-nutrient preload method, which has been developed to treat and prevent obesity and type 2 diabetes (T2DM). Diet control is not only beneficial for controlling maternal weight and improving hyperglycemia, it can also raise the insulin sensitivity in target tissues. Nutritional therapy can maintain blood glucose at a normal level and ensure that the mother's physiological requirements and the fetus' developmental requirements are met. has a strong and undisputable scientific support. A prerequisite for the introduction of this kind of healthy nutrition to the general public is that “Medical Nutrition Therapy (MNT)” is evidence based, i.e. ![]() The need for both preventive and therapeutic measures is now urgent, where life style changes, most importantly introduction of healthy diets, are crucial. A positive screening test must be linked to a safe and effective method to treat the hyperglycemia and its feared short and long term consequences. The screening and diagnosis of GDM are important as are interventions aiming to reduce adverse outcomes during pregnancy, immediately after delivery and in a long term perspective. One feature of GDM is that the disease is often asymptomatic, patients rarely have any symptoms at the time of diagnosis (often at week 24–28), and an important aspect of treatment concerns life style changes. ![]() This adds to the burden many are facing in the prevention of T2DM and its micro- and macrovascular consequences. GDM in itself can cause epigenetic “programming” of the fetal metabolism and maternal hyperglycemia can therefore potentially lead to trans-generational effects with increased disease risks for the offspring. Likewise, their offspring have an increased risk at birth and increased risk of diabetes and obesity later in life. Women with a history of GDM have an increased risk of complications during delivery and have a sevenfold increased risk of getting diabetes later in life. In 2007, the Obstetrics Branch of the Chinese Medical Association conducted a nationwide epidemiological study of patients with GDM, showing that the average prevalence of GDM in China was 6.6% with a trend of yearly increases, confirmed by a population-based study in Tianjin 2012, where the prevalence of GDM was 8.1% using the 1999 WHO criteria which was further increased to 9.3% if the 2010 IADPSG criteria were used. It accounts for 80–90% of diabetes in pregnancy and includes gestational impaired glucose tolerance. Gestational diabetes mellitus (GDM) refers to glucose tolerance abnormalities of varying degrees that occur or are first discovered during pregnancy. ![]()
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