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In-depth Medical Nutrition Therapy for a Woman with Diabetes: From Pregnancy to Delivery
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논문 기본 정보

Type
Academic journal
Author
MiyoungJang (Seoul National University College of Medicine) Dal Lae Ju (Seoul National University Hospital) meera kweon (Seoul National University Hospital) Misun Park
Journal
한국임상영양학회 Clinical Nutrition Research Clinical Nutrition Research Vol.5 No.4 KCI Accredited Journals
Published
2016.1
Pages
305 - 309 (5page)

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In-depth Medical Nutrition Therapy for a Woman with Diabetes: From Pregnancy to Delivery
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Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process.

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References (10)

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International Diabetes Federation / 2009 / Global guideline on pregnancy and diabetes / International Diabetes Federation google schola Ray JG / 2004 / Risk of congenital anomalies detected during antenatal serum screening in women with pregestational diabetes / QJM 97:651~653 google schola Kitzmiller JL / 1996 / Pre-conception care of diabetes, congenital malformations, and spontaneous abortions / Diabetes Care 19:514~541 google schola Ray JG / 2001 / Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus : a meta-analysis / QJM 94:435~444 google schola Hadden D / 1998 / Outcome of pregnancy in women with insulin dependent diabetes. Centralisation of care leads to better outcome / BMJ 316:550 google schola

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