GEBELİKTE BESLENME DURUMU İLE GLUKOZ TOLERANSI ARASINDAKİ İLİŞKİLER

Öz

Amaç: Gestasyonel diabetes mellitus (GDM), gebelik esnasında ortaya çıkan ve tedavi edilmediğinde hem maternal hem de fetal açıdan olumsuz sonuçlara neden olabilen bir diyabet formudur. Çalışmamızda; gebelikte beslenme özellikleri ile GDM ve gestasyonel glukoz intoleransı (GGİT) gelişimi arasındaki ilişkilerin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya oral glukoz tolerans testi (OGTT- 50 g ve 100 g) sonuçlarına göre; normal glukoz toleransı (NGT, n=60), GGİT (n=60) ve GDM (n=60) olmak üzere üç grup gebe dahil edilmiştir. Katılımcıların demografik özellikleri, sağlık durumları ve beslenme alışkanlıkları sorgulanmış, ayrıca hastalardan üç günlük besin tüketim kayıtları istenmiştir. Bulgular: Gestasyonel diabetes mellitus ve GGİT gruplarında ortalama yaş, vücut ağırlığı, günlük karbonhidrat ve protein alım miktarları ve ailede diyabet öyküsü sıklığı NGT grubundan daha yüksek bulunmuş; GDM grubunda ayrıca yağ alım miktarının da, NGT ve GGİT gruplarından daha yüksek olduğu saptanmıştır (p<0,05). Lojistik regresyon modellerine göre yaş; günlük protein, karbonhidrat ve yağ tüketimleri; daha önce gebe kalmamış olmak ve gebelik öncesi vücut kitle indeksinin (VKİ)>25 kg/m2 olması GDM riski ile; benzer şekilde yaş, günlük protein tüketimi, daha önce iri bebek doğurmuş olmak ve sigara kullanmak GGİT riski ile pozitif yönde ilişkili bulunmuştur. Sonuç: Gebelerde beslenme alışkanlıkları ile birlikte fenotipik özellikler, ailede diyabet öyküsü ve daha önceki obstetrik sorunların; GDM veya GGİT riski ile yakından ilişkili olduğu saptanmıştır. Özellikle yüksek riskli gebelerde genel sağlığa ve dengeli beslenmeye özel bir önem atfedilmelidir.

Anahtar Kelimeler

• Gestasyonel diabetes mellitus
• gestasyonel glukoz intoleransı
• beslenme tarzı
• oral glukoz tolerans testi

THE RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND GLUCOSE TOLERANCE IN PREGNANCY

Öz

Objective: Gestational diabetes mellitus (GDM) is a form of diabetes that appears during pregnancy and can cause both maternal and fetal consequences if left untreated. The aim of this study was to investigate the relationship between the nutritional characteristics of pregnancy and the development of GDM and gestational glucose intolerance (GGIT). Material and Method: Three groups of pregnant women were included in the study. They were grouped according to the results of the oral glucose tolerance test (OGTT-50 g and 100 g) as follows: normal glucose tolerance (NGT, n=60), GGIT (n=60), and GDM (n=60). The demographic characteristics, health conditions, and nutritional habits of the participants were questioned, and a 3-day food consumption record was requested from the patients. Results: Average age, body weight, daily carbohydrate and protein intakes, and the frequency of diabetes history in the family were found to be higher in the GDM and GGIT groups than in the NGT group. It was also found that the amount of fat intake was higher in the GDM group than in the NGT and GGIT groups (p<0.05). According to logistic regression models, age, daily protein, carbohydrate, and fat consumption, not being pregnant before, and having a body mass index (BMI)>25 kg/m2 before pregnancy were the factors associated with the risk of GDM. Similarly, age, daily protein consumption, having a macrosomic baby, and current smoking were positively associated with the risk of GGIT. Conclusion: The phenotypic characteristics, family history of diabetes, and previous obstetric problems in pregnant women were found to be closely related to GDM or GGIT risk. Special attention should be paid to general health and balanced nutrition, especially in high-risk pregnant women.

Anahtar Kelimeler

• Gestational diabetes mellitus
• gestational glucose intolerance
• nutrition style
• oral glucose tolerance test

Kaynakça

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