Effect of 3-day intensive dietary therapy during admission in women after diagnosis of gestational diabetes mellitus.

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dc.contributor.authorSunsaneevithayakul, Praserten_US
dc.contributor.authorRuangvutilert, Pornpimolen_US
dc.contributor.authorSutanthavibul, Anuwaten_US
dc.contributor.authorKanokpongsakdi, Sujinen_US
dc.contributor.authorBoriboohirunsarn, Dittakarnen_US
dc.contributor.authorRaengpetch, Yoopinen_US
dc.contributor.authorLertpadungkulchai, Supanneeen_US
dc.date.accessioned2009-05-27T20:18:28Z
dc.date.available2009-05-27T20:18:28Z
dc.date.issued2004-09-02en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractOBJECTIVE: 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.affiliationDepartment of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.en_US
dc.identifier.citationSunsaneevithayakul 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): 1022-8en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/42755
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshDiabetes, Gestational --diet therapyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlucose Tolerance Testen_US
dc.subject.meshHumansen_US
dc.subject.meshInsulin --therapeutic useen_US
dc.subject.meshPregnancyen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshThailand --epidemiologyen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleEffect of 3-day intensive dietary therapy during admission in women after diagnosis of gestational diabetes mellitus.en_US
dc.typeJournal Articleen_US
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