The Effects of Medical Nutrition and Insulin Therapy on Diabetic Pregnant Women and Their Children ’s Health

Abstract

This study was conducted on 55 women with gestatio n a l diabetes mellitus (GDM) who were attended to Zekai Tahir Burak Women Hospital. Although the OGTT was req u ired by World Health Organization between 24th and 28th weeks o f gestation, however in this study OGTT was applied after the 24th week o f gestation. Because in Turkey most o f the pregnant women do not attend to the hospital at early weeks o f gestation (before 28th weeks). GDM were diagnosed by 50 g glucose challenge test (blood glucose 140 mg/dL) or 100 g oral glucose tolerance test (OGTT). Although 49.6 % o f GDM were identifıed in normal BMI, obesity was very high 56.4% (ovenveight, İst, 2nd morbid) in prepregnancy period. The mean weight gain was 10.8 ± 4.6 kg at the end o f pregnancy. The medical n u tritional therapy was given to each GDM women (mean education time 42.5 ± 27.0 min) and they were monitorized by monthly visits. According to the preassessment o f the nutritional status o f pregnants o f GDM, energy (52.7 %>), protein (63.6 %), calcium (30.9 %), iron (40.0 %) and zinc (56.4 %) intakes were 75-100 % o f their daily requirements. After the nutritional education, energy (70.9 %), calcium (72.7 %), iron (58.1 %) and zinc (80.0 %) intakes were increased during pregnancy. During the diagnosis 14.3 % o f women had higher levels than normal range o f HbAlc and at the end o f the pregnancy 33.3 % o f women had higher levels than normal range (p< 0.05). After the nutrition education fasting and 2nd hour postprandial blood glucose levels were fo u n d 95.1 % and 82.6 % GDM women (105 mg/dL a n d 120 mg/dL), respectively. Clinical outcomes and anthropometric measurements were fo u n d normal o f GDM women's babies who were screened during pregnancy. It was concluded that by the following appropriate nutrition counselling, both fasting and postprandial glucose levels were decreased, and the number o f women who had normal glucose levels were increased.