PurposeThis study investigated the effects of attending a one-day outpatient service on the outcomes of patients with gestational diabetes mellitus (GDM) and different pre-pregnancy body mass indices (BMIs).MethodsThe study recruited 311 pregnant women with GDM into a one-day outpatient service at The Fourth Hospital of Shijiazhuang from September 2019 to December 2021. They were randomly assigned to three groups, based on their pre-pregnancy BMI as follows: group A, BMI < 18.5 kg/m2; group B, 18.5 ≥ BMI > 25.0 kg/m2; group C, BMI ≥25 kg/m2. The following information was collected from all the participants: fasting blood glucose, hemoglobin A1c (HbA1C), insulin dose, gestational weight gain, weight gain after the one-day outpatient service, and perinatal outcomes.ResultsThe three groups showed significant differences in fasting blood glucose and HbA1C, insulin treatment rate, and the incidence of pregnancy hypertension/preeclampsia and neonatal jaundice (all P < 0.05). The rate of excessive gestational weight gain in all of the groups also reflected significant differences (P < 0.05). Group A showed the lowest weight gain, while group C gained the most weight. There is no significant difference in the incidences of hypertension/preeclampsia, neonatal jaundice, or premature birth between patients with weight loss/no weight gain and those with positive weight gain.ConclusionOne-day diabetes outpatient integrated management may effectively help to manage weight gain and blood glucose in patients with GDM and different pre-pregnancy BMIs. Dietary control after a GDM diagnosis may have helped to avoid weight gain entirely, as well as negative weight gain, but did not increase the risk of maternal and infant-related complications.
Objective The aim of the present study was to explore the impact of the one-day clinic diabetes mellitus (DM) management model on perinatal outcomes in patients with gestational diabetes mellitus (GDM). Methods A total of 995 patients who underwent prenatal checkups at our hospital and were diagnosed with GDM by oral glucose tolerance test (OGTT) screening at 24–28 weeks of gestational age were enrolled between December 2018 and August 2020. The patients were randomly divided into a study group (541 cases) and a control group (454 cases). One-day clinic intervention for DM was conducted in the study group, while individualized dietary interventions and exercise instruction were given in the control group. The perinatal outcomes of patients were compared between the two groups. Results In the study group, maternal weight gain, fasting blood glucose before delivery, the incidence of abnormality in postpartum OGTT, and abnormality of pancreatic islet function were lower than in the control group, and the differences were statistically significant ( P < 0.05). The percentage of patients with insulin treatment in the study group was higher than in the control group, and the difference was statistically significant ( P < 0.05). The incidence of premature rupture of membranes, macrosomia, and neonatal jaundice was lower in the study group than in the control group, and the differences were statistically significant ( P < 0.05). Conclusion The one-day clinic DM management model can effectively control weight gain and blood glucose levels during pregnancy in patients with GDM, resulting in a higher recovery rate of blood glucose and islet function after delivery and a lower incidence of premature rupture of membranes, macrosomia, and neonatal jaundice. The one-day clinic DM management model could therefore have profound implications for reducing and delaying the onset of postpartum type 2 diabetes in patients with GDM.
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