Result of Ambulatory Diet Therapy in Gestational Diabetes Mellitus
Prasert Sunsaneevithayakul MD*, Sujin Kanokpongsakdi MD*, Anuwat Sutanthavibul MD*, Pornpimol Ruangvutilert MD, PhD*, Dittakarn Boriboohirunsarn MD, MPH, PhD*, Teanta Keawprasit BNS**, Ruanthip Tantawattana BNS**
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University ** Obstetrics and Gynecology Nursing, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University
Objectives : To evaluate the effectiveness of an ambulatory program for glycemic control of women with
gestational diabetes mellitus (GDM).
Materials and Methods : A total of 33 women with GDM whose FBS from OGTT > 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 > 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.
Conclusion : 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.
Keywords : Ambulatory program, Dietary therapy, Gestational diabetes mellitus
