Abstract:
Gestational diabetes mellitus (GDM) represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term. Lifestyle intervention remains the mainstay for the management of GDM. The efficacy of nutritional approaches (e.g. calorie restriction and small frequent meals) to improving the maternal-neonatal outcomes of GDM was attested to by Chinese population data, discussed in two articles in recent issues of this journal. However, a specific focus on the relevance of postprandial glycaemic control was lacking. Postprandial rather than fasting hyperglycaemia often represents the predominant manifestation of disordered glucose homeostasis in Chinese women with GDM. There is now increasing appreciation that the rate of gastric emptying, which controls the delivery of nutrients for digestion and absorption in the small intestine, is a key determinant of postprandial glycaemia in both health, type 1 and 2 diabetes. It remains to be established whether gastric emptying is abnormally rapid in GDM, particularly among Chinese women, thus contributing to a predisposition to postprandial hyperglycaemia, and if so, how this influences the therapeutic response to nutritional interventions. It is essential that we understand the role of gastric emptying in the regulation of postprandial glycaemia during pregnancy and the potential for its modulation by nutritional strategies in order to improve post-prandial glycaemic control in GDM.
摘要:
妊娠期糖尿病(GDM)是妊娠最常见的医学并发症之一,对母亲和后代的短期和长期健康都很重要。生活方式干预仍然是GDM管理的支柱。中国人口数据证明了营养方法(如热量限制和少量频繁进餐)改善GDM母婴结局的有效性,在本刊最近两期的文章中进行了讨论。然而,缺乏对餐后血糖控制相关性的特别关注.餐后而不是空腹高血糖通常代表中国GDM女性血糖稳态紊乱的主要表现。现在越来越多的人认识到胃排空的速度,它控制着小肠消化和吸收的营养物质的输送,是两种健康中餐后血糖的关键决定因素,1型和2型糖尿病。GDM患者的胃排空是否异常迅速仍有待确定。尤其是在中国女性中,因此有助于餐后高血糖的易感性,如果是这样,这如何影响营养干预的治疗反应。我们必须了解胃排空在妊娠期餐后血糖调节中的作用以及营养策略对其调节的潜力,以改善GDM的餐后血糖控制。