Effect of 3-day intensive dietary therapy during admission in women after diagnosis of gestational diabetes mellitus.
dc.contributor.author | Sunsaneevithayakul, Prasert | en_US |
dc.contributor.author | Ruangvutilert, Pornpimol | en_US |
dc.contributor.author | Sutanthavibul, Anuwat | en_US |
dc.contributor.author | Kanokpongsakdi, Sujin | en_US |
dc.contributor.author | Boriboohirunsarn, Dittakarn | en_US |
dc.contributor.author | Raengpetch, Yoopin | en_US |
dc.contributor.author | Lertpadungkulchai, Supannee | en_US |
dc.date.accessioned | 2009-05-27T20:18:28Z | |
dc.date.available | 2009-05-27T20:18:28Z | |
dc.date.issued | 2004-09-02 | en_US |
dc.description | Chotmaihet Thangphaet. | en_US |
dc.description.abstract | OBJECTIVE: To determine the impact of 3-day intensive dietary therapy during admission on glycemic control. MATERIAL AND METHOD: GDM women, with level of fasting blood glucose (FBS) at or above 105 mg/dl on their oral glucose tolerance test (OGTT), were hospitalized. After 3-day intensive dietary therapy, the women were stratified by FBS value and mean 2-hour postprandial blood glucose. Those with poor glycemic control, FBS at or above 105 mg/dl, were prescribed insulin therapy. RESULT: Between 1 August 2001 to 31 December 2002, a total of 9861 pregnant women were screened for clinical risk factors of GDM at their first antenatal visits, and 4663 had at least 1 risk. After 50-gm glucose challenge test and 100-gm OGTT GDM was diagnosed in 300 women. Only 18% (54 in 300 cases) of GDM had level of FBS at or above 105 mg/dl on OGTT. They were admitted in a special ward for further investigation and initial management. After 3 days of intensive dietary therapy, the FBS and mean 2-hour postprandial blood glucose level were monitored and stratified in 3 groups. Only 42.6% of admission group (23 in 54 cases) still had FBS at or above 105 mg/dl and required insulin therapy (group 1). One third (18 in 54 cases) could avoid insulin therapy due to the level of FBS below 105 mg/dl and mean 2-hour postprandial blood glucose below 120 mg/dl (group 2). This second group was discharged, and due to attend the high risk pregnancy clinic a few weeks later The third group (group 3), comprising one fourth (13 in 54 cases), had FBS below 105 mg/dl but had a mean 2-hour postprandial blood glucose at or above 120 mg/dl. This third group were also discharged and were monitored glycemic profile by FBS and 2-hour postprandial blood glucose every time during their visits to the high risk pregnancy clinic. According to criteria of 2-hour postprandial blood glucose at or above 120 mg/dl on two or more occasions within a 1-2 weeks interval, no one in group 3 needed insulin therapy afterward CONCLUSION: GDM women with FBS at or above 105 mg/dl on their OGTT, should be prescribed intensive dietary therapy alone for 3 days inside hospital rather than initiating insulin immediately after diagnosis. One third had a benefit of avoiding insulin therapy. Only 42% failed to achieve good glycemic control and still needed insulin therapy. One fourth showed optimal glycemic control after this intervention (FBS below 105 mg/dl) but had mean 2-hour postprandial blood glucose at or above 120 mg/dl. Longer trial of dietary therapy should be considered in this last group to avoid over treatment of insulin therapy. | en_US |
dc.description.affiliation | Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand. | en_US |
dc.identifier.citation | Sunsaneevithayakul P, Ruangvutilert P, Sutanthavibul A, Kanokpongsakdi S, Boriboohirunsarn D, Raengpetch Y, Lertpadungkulchai S. Effect of 3-day intensive dietary therapy during admission in women after diagnosis of gestational diabetes mellitus. Journal of the Medical Association of Thailand. 2004 Sep; 87(9): 1022-8 | en_US |
dc.identifier.uri | https://imsear.searo.who.int/handle/123456789/42755 | |
dc.language.iso | eng | en_US |
dc.source.uri | https://www.mat.or.th/journal/all.php | en_US |
dc.subject.mesh | Adolescent | en_US |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Diabetes, Gestational --diet therapy | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Glucose Tolerance Test | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Insulin --therapeutic use | en_US |
dc.subject.mesh | Pregnancy | en_US |
dc.subject.mesh | Prospective Studies | en_US |
dc.subject.mesh | Risk Factors | en_US |
dc.subject.mesh | Thailand --epidemiology | en_US |
dc.subject.mesh | Time Factors | en_US |
dc.subject.mesh | Treatment Outcome | en_US |
dc.title | Effect of 3-day intensive dietary therapy during admission in women after diagnosis of gestational diabetes mellitus. | en_US |
dc.type | Journal Article | en_US |
Files
License bundle
1 - 1 of 1