收稿日期: 2021-05-13
网络出版日期: 2021-11-26
基金资助
南方医科大学第五附属医院院长基金项目(YZ2020-ZX12)
Evidence summary of diet management for patients with gestational diabetes mellitus
目的 检索并评价妊娠期糖尿病孕妇饮食管理的相关证据,为临床护理实践提供依据。方法 计算机检索BMJ Best Practice、JBI、UpToDate、Cochrane Library、国际指南协作网、中国知网、医脉通等国内外数据库中所有关于妊娠期糖尿病孕妇饮食管理的证据,检索时限为建库至2021年2月。由2名研究者使用临床指南研究与评价系统对指南进行质量评价,使用多重系统评价评估工具对系统评价进行质量评价,使用JBI循证卫生保健中心对应的评价标准（2016）对临床决策进行质量评价,使用JBI循证卫生保健中心的专家意见和专家共识类的文献质量评价工具对专家共识进行评价,并进行证据提取及汇总。结果 共纳入13篇文献,其中临床实践指南8篇,系统评价3篇,临床决策1篇,专家共识1篇。经过评价,从妊娠期糖尿病孕妇饮食管理的目标、评估、体质量管理、营养素推荐、饮食结构、健康教育6个方面总结出27条证据。结论 本研究总结了妊娠期糖尿病孕妇饮食管理的最佳证据,为临床护理人员对妊娠期糖尿病孕妇进行饮食管理提供了循证依据。但由于本研究总结的证据来自多个国家,护理人员在应用时应充分评估临床情境,结合孕妇的饮食习惯及偏好,为其制订个性化的饮食管理方案。
曹亚男 , 朱燕妮 , 王娜娜 , 钟赛琼 , 陆燕英 , 钟丽玲 , 董兰菊 , 翟燕珍 . 妊娠期糖尿病孕妇饮食管理的证据总结[J]. 中华护理教育, 2021 , 18(11) : 1040 -1045 . DOI: 10.3761/j.issn.1672-9234.2021.11.015
Objective To search and evaluate the relevant evidence of diet management for pregnant women with gestational diabetes mellitus（GDM）. Methods We searched the literatures on the diet management for pregnant women with GDM in the following databases：BMJ Best Practice,JBI,UpToDate,Cochrane Library,GIN,CNKI,and Medlive from their inception to February 2021. Two researchers used AGREE Ⅱ,AMSTAR and JBI Evidence-based Health Care Center evaluate standards（2016） and expert concensus for quality evaluation and conducted data extraction. Results Totally 13 papers were selected,including 8 clinical practice guidelines,3 systematic reviews,1 clinical decision and 1 expert consensus. A total of 27 items of best evidence were summarized from 6 aspects including diet management goal,evaluation,BMI management,nutrient,diet structure and health education. Conclusion This study summarizes the best evidence of dietary management for pregnant women with GDM. As evidence summarized in this study from several countries,nurses should fully evaluate the clinical situation and formulate individualized diet management schedule for pregnant women with GDM with the consideration of their eating habits and preferences.
Key words： Diabetes,Gestational; Evidence-Based Nursing; Diet management
| [1] | Tucker ME. IDF atlas:about 415 million adults worldwide have diabetes[EB/OL].(2015-12-02)[2021-04-10]. http://www.medscape.com/viewarticle/855296. |
| [2] | Hernandez TL, Brand-Miller JC. Nutrition therapy in gestational diabetes mellitus:time to move forward[J]. Diabetes Care, 2018, 41(7):1343-1345. |
| [3] | Hoffmann-Eβer W, Siering U, Neugebauer EAM, et al. Guideline appraisal with AGREE Ⅱ:systematic review of the current evidence on how users handle the 2 overall assessments[J]. PLoS One, 2017, 12(3):e0174831. |
| [4] | 熊俊, 陈日新. 系统评价/Meta分析方法学质量的评价工具AMSTAR[J]. 中国循证医学杂志, 2011, 11(9):1084-1089. |
| [4] | Xiong J, Chen RX. An introduction to a measurement tool to assess the methodological quality of systematic reviews/Meta-analysis:AMSTAR[J]. Chin J Evid-Based Med, 2011, 11(9):1084-1089. |
| [5] | 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967. |
| [5] | Wang CQ, Hu Y. JBI evidence pre-rangking and recommended system(2014 Edition)[J]. J Nurses Train, 2015, 30(11):964-967. |
| [6] | Kleinwechter H, Schäfer-Graf U, Bührer C, et al. Gestational diabetes mellitus(GDM)diagnosis,therapy and follow-up care:Practice Guideline of the German Diabetes Association(DDG)and the German Association for Gynaecologyand Obstetrics(DGGG)[J]. Exp Clin Endocrinol Diabetes, 2014, 122(7):395-405. |
| [7] | 杨慧霞, 徐先明, 王子莲, 等. 妊娠合并糖尿病诊治指南(2014)[J]. 糖尿病天地(临床), 2014, 8(11):489-498. |
| [7] | Yang HX, Xu XM, Wang ZL, et al. Guidelines for diagnosis and treatment of gestational diabetes mellitus(2014)[J]. Clin J Dia-betes World, 2014, 8(11):489-498. |
| [8] | Hod M, Kapur A, Sacks DA, et al. The International Federation of Gynecology and Obstetrics(FIGO) Initiative on gestational diabetes mellitus:a pragmatic guide for diagnosis,management,and care[J]. Int J Gynaecol Obstet, 2015, 131(Suppl 3):S173-S211. |
| [9] | The National Institute for Health and Care Excellence（NICE）. Diabetes in pregnancy:management from preconception to the postnatal period[EB/OL]. (2015-02-15)[2021-04-18]. https://www.nice.org.uk/guidance/ng3. |
| [10] | The American College of Obstetricians and Gynecologists. Practice bulletin No.180:gestational diabetes mellitus[J]. Obstet Gynecol, 2017, 130(1):e17-e31. |
| [11] | Malaysia Health Technology Assessment Section（MaHTAS）. Management of diabetes in pregenancy[EB/OL]. (2017-01-01)[2021-04-22]. http://www.moh.gov.my/index.php/pages/view/134. |
| [12] | Duarte-Gardea MO, Gonzales-Pacheco DM, Reader DM, et al. Academy of nutrition and dietetics gestational diabetes evidence-based nutrition practice guideline[J]. J Acad Nutr Diet, 2018, 118(9):1719-1742. |
| [13] | Queensland Clinical Guidelines. Gestational diabetes mellitus(GDM)[M]. Queensland:Queensland Health, 2021: 25-27. |
| [14] | Han S, Crowther CA, Middleton P, et al. Different types of dietary advice for women with gestational diabetes mellitus[J]. Cochrane Database Syst Rev, 2013(3):CD009275. |
| [15] | Martis R, Crowther CA, Shepherd E, et al. Treatments for women with gestational diabetes mellitus:an overview of Cochrane systematic reviews[J]. Cochrane Database Syst Rev, 2018, 8:CD012327. |
| [16] | Yamamoto JM, Kellett JE, Balsells M, et al. Gestational diabetes mellitus and diet:a systematic review and meta-analysis of randomized controlled trials examining the impact of modified dietary interventions on maternal glucose control and neonatal birth weight[J]. Diabetes Care, 2018, 41(7):1346-1361. |
| [17] | Durnwald C. Gestational diabetes mellitus：glycemic control and maternal prognosis[EB/OL].(2020-09-29)[2021-04-13]. https:// www.uptodate.cn/contents/zh-Hans/gestational-diabetes-mellitus-glycemic-control-and-maternal-prognosis?search=%20Gestational%20diabetes%20mellitus%EF%BC%9Aglycemic%20control%20and%20maternal%20prognosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. |
| [18] | 周英凤, 章孟星, 李丽, 等. 《妊娠期糖尿病临床护理实践指南》推荐意见专家共识[J]. 护理研究, 2020, 34(24):4313-4318. |
| [18] | Zhou YF, Zhang MX, Li L, et al. Expert consensus study on recommendations of clinical nursing practice guidelines for gestational diabetes mellitus[J]. Chin Nurs Res, 2020, 34(24):4313-4318. |
| [19] | Hartling L, Dryden DM, Guthrie A, et al. Benefits and harms of treating gestational diabetes mellitus:a systematic review and meta-analysis for the U.S. Preventive Services Task Force and the National Institutes of Health Office of Medical Ap-plications of Research[J]. Ann Intern Med, 2013, 159(2):123-129. |
| [20] | Viana LV, Gross JL, Azevedo MJ. Dietary intervention in patients with gestational diabetes mellitus:a systematic review and meta-analysis of randomized clinical trials on maternal and newborn outcomes[J]. Diabetes Care, 2014, 37(12):3345-3355. |
| [21] | Han S, Crowther CA, Middleton P. Interventions for pregnant women with hyperglycaemia not meeting gestational diabetes and type 2 diabetes diagnostic criteria[J]. Cochrane Database Syst Rev, 2012, 1:CD009037. |
| [22] | 郭燕华, 寇丽红, 张映, 等. 我国妊娠期糖尿病医学营养治疗现状[J]. 护理研究, 2020, 34(23):4267-4270. |
| [22] | Guo YH, Kou LH, Zhang Y, et al. Status quo of medical nutrition therapy for gestational diabetes mellitus in China[J]. Chin Nurs Res, 2020, 34(23):4267-4270. |
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