Result of ambulatory diet therapy in gestational diabetes mellitus.
OBJECTIVE
To evaluate the effectiveness of an ambulatory program for glycemic control of women with gestational diabetes mellitus (GDM).


METHODS
A total of 33 women with GDM whose FBS from OGTT > or = 105 mg/dl were scheduled to attend weekly ambulatory care for dietary therapy with their family. FBS and 2-hour postprandial blood glucose were monitored every visit for a few weeks. At the end of this program, those with poor glycemic control were admitted for further tight dietary control by conventional 3-day course after which insulin was finally started for the women whose glycemic control remained poor.


RESULTS
After the ambulatory program, 14 of 33 cases (42.4%) achieved good glycemic control without hospitalization. Another 6 cases (18.2%) did not need insulin therapy after admission for 3-day intensive dietary therapy. Altogether, 20 out of 33 cases (60.6%) of GDM whose FBS from OGTT > or = 105 mg/dl could avoid insulin therapy after attending the ambulatory program alone or with additional 3-day intensive dietary therapy course. Similar effectiveness was observed from the authors' previous study on 3-day intensive dietary therapy alone.


CONCLUSIONS
The authors' current ambulatory dietary therapy program has shown to be effective in achieving good glycemic control and avoiding unnecessary insulin therapy and admission in most cases of women with GDM. In the future, an even more effective ambulatory diet control may ascertain that once a woman is hospitalized, insulin should be started right away.
Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Prasert
P
Sunsaneevithayakul
Sujin
S
Kanokpongsakdi
Anuwat
A
Sutanthavibul
Pornpimol
P
Ruangvutilert
Dittakarn
D
Boriboohirunsarn
Teanta
T
Keawprasit
Ruanthip
R
Tantawattana
D000328:Adult; D000553:Ambulatory Care; D001786:Blood Glucose; D016640:Diabetes, Gestational / Q000178:diet therapy* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D019518:Postprandial Period; D011247:Pregnancy; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin