مقایسه تبعیت از رژیم غذایی زنان مبتلا به دیابت بارداری تحت درمان با رژیم غذایی در دو گروه با و بدون مصرف بامیه

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 مربی گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 مرکز تحقیقات فارماکولوژی گیاهان دارویی، دانشگاه علوم پزشکی مشهد، مشهد، ایران. استادیار گروه فارماکولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

5 استاد گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

10.22038/ijogi.2019.14001

چکیده

مقدمه: پیروی از رژیم غذایی دیابتی، از مهم‌ترین چالش­ها در کنترل دیابت بارداری است. ممکن است افراد با دریافت درمان مکمل در کنار رعایت رژیم غذایی، خود را بیشتر در معرض خطر دیده و تبعیت از رژیم بیشتری جهت کنترل قند خون طی بارداری داشته باشند. لذا مطالعه حاضر با هدف مقایسه تبعیت از رژیم غذایی زنان مبتلا به دیابت بارداری در دو گروه با و بدون مصرف بامیه انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 98-1397  بر روی 60 نفر از زنان مبتلا به دیابت بارداری تحت درمان با رژیم غذایی انجام شد. افراد به‌صورت تصادفی به دو گروه مداخله و کنترل تخصیص یافتند. به افراد هر دو گروه، رژیم غذایی معمول دیابت بارداری به‌صورت حضوری آموزش داده شد. گروه مداخله علاوه بر این، روزانه 6 گرم پودر بامیه در وعده صبحانه و نهار مصرف می­کردند. پرسشنامه تبعیت از رژیم غذایی در ابتدا و 4 هفته بعد از مطالعه توسط واحد پژوهش تکمیل گردید. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماریSPSS  (نسخه 21) و آزمون­های آماری تی مستقل، تی زوجی، من‌ویتنی، ویلکاکسون و آنالیز واریانس دوطرفه انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: تغییر نمره تبعیت از رژیم غذایی بعد نسبت به قبل از مداخله در گروه مداخله نسبت به گروه کنترل تفاوت آماری معنی‌داری نداشت (087/0=p). در مقایسه درون‌‌گروهی در هر دو گروه، تغییر نمره تبعیت از رژیم غذایی بعد نسبت به قبل از مداخله معنی‌دار بود (001/0>p).
نتیجه‌گیری: در مطالعه حاضر، مصرف طب مکمل تبعیت از رژیم غذایی را تحت تأثیر قرار نداد و تبعیت از رژیم در گروهی که طب مکمل را در کنار رعایت رژیم غذایی دریافت می‌کردند نسبت به گروهی که تنها رژیم غذایی رعایت می‌کردند، تفاوتی نداشت.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of adherence to the diet of women with gestational diabetes under diet therapy between the groups of with and without okra powder

نویسندگان [English]

  • Mahla Salarfard 1
  • Zahra Abedian 2
  • Seyed Reza Mazloum 3
  • Hasan Rakhshande 4
  • Farideh Akhlaghi 5
1 M.Sc. Student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Instructor, Department of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Pharmacology Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran. Assistant professor, Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5 Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Following the diabetic diet is of the most important challenges in controlling gestational diabetes. Maybe people receive a complementary therapy alongside with diet observance and found themselves more at risk, and have more adherence to the diet to control blood sugar during pregnancy. Therefore, this study was performed with aim to compare adherence to the diet of women with gestational diabetes between the groups of with and without okra powder.
Methods: This clinical trial was performed in 2018-2019 on 60 women with gestational diabetes mellitus who were under treatment with diet. The subjects were randomly assigned to intervention and control groups. Usual diet of gestational diabetes was trained in person for both groups. The intervention group in addition to this used 6 gr of okra powder daily at breakfast and lunch. Adherence to dietary questionnaire was completed at baseline and four weeks after the study by the research unit. Data were analyzed by SPSS software (version 21) and independent t-test, paired-t, Mann-Whitney test, Wilcoxon and covariance analysis. P<0.05 was considered statistically significant.
Results: Changes in diet adherence score after the intervention than before it had no significant difference in the intervention group compared to the control group (P=0.087). In the intergroup comparison in both groups, change in diet adherence after the intervention than before it was significant (P<0.001).
Conclusion: In the present study, the use of supplemental medicine did not affect diet adherence. Diet adherence in the group which received complementary medicine in addition to diet had no difference compared with the group which only received the diet.

کلیدواژه‌ها [English]

  • Adherence to diet
  • Gestational Diabetes Mellitus
  • okra powder
  1. Moore LE, Catalano P. Diabetes in pregnancy. New York: Springer; 2018.
  2. Agarwal MM. Gestational diabetes mellitus: an update on the current international diagnostic criteria. World J Diabetes 2015; 6(6):782-91.
  3. Akhondian M, Mirmiran P, Rashidkhani B, Asghari G. Relationship between gestational diabetes and dietary patterns. Iran J Diabetes Lipid Disord 2012; 11(3):309-20. (Persian).
  4. Cuninngham F, Leveno K, Bloom SL, Spong CY, Dash J, Hofman BL, et al. Williams obstetrics. 25th ed. New York: McGraw-Hill; 2018.
  5. Kopp W. Role of high-insulinogenic nutrition in the etiology of gestational diabetes mellitus. Med Hypotheses 2005; 64(1):101-3.
  6. Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am 2007; 34(2):173-99.
  7. Almasi S, Salehiniya H. The prevalence of gestational diabetes mellitus in Iran (1993-2013): a systematic review. J Isfahan Med Sch 2014; 32(299):1396-412. (Persian).
  8. Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, Naghavi-Behzad M, Piri R, Pourali-Akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: a systematic review and meta-analysis. Iran J Public Health 2015; 44(8):1036-44.
  9. Ju H, Rumbold AR, Willson KJ, Crowther CA. Borderline gestational diabetes mellitus and pregnancy outcomes. BMC Pregnancy Childbirth 2008; 8(1):31.
  10. Noroozi A, Tahmasebi R, Rekabpour SJ. Effective social support resources in self- management of diabetic patients in Bushehr (2011-12). Iran South Med J 2013; 16(3):250-9. (Persian).
  11. Zamanfar D, Farhadi R, Shahbaznejad L. Neonate of diabetic mother, pathogenesis and complications. Clin Exc 2014; 2(2):90-103. (Persian).
  12. Kordi M, Banaei M, Asgharipour N, Mazloum SR, Akhlaghi F. Prediction of self-care behaviors of women with gestational diabetes based on belief of person in own ability (self-efficacy). Iran J Obstet Gynecol Infertil 2016; 19(13):6-17. (Persian).
  13. Brown J, Crawford TJ, Alsweiler J, Crowther CA. Dietary supplementation with myo‐inositol in women during pregnancy for treating gestational diabetes. Cochrane Database Syst Rev 2016; 9:CD012048.
  14. Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes Care 2007; 30(Suppl 2):S251-60.
  15. Salehmoghadam A, Khosravi Banjar A, Karimi Moonaghi H, Gholami H. An investigation of the effect of E-learning education method on dietary regimen in type 2 diabetic patients. Evid Based Care 2013; 3(3):51-8. (Persian).
  16. Kooshyar H, Shoorvazi M, Dalir Z, Hosseini M. Health literacy and its relationship with medical adherence and health-related quality of life in diabetic community-residing elderly. J Mazandaran Univ Med Sci 2014; 23(1):134-43. (Persian).
  17. Paryad E, Kazemnezhad Leili E, Booraki S, SadeghiMeibodi A, Nassiri Sheikhani N. Study status of care adherence and its related factors in patients undergoing. J Holist Nurs Midwifery 2015; 25(3):34-45.
  18. Bosworth HB, Oddone EZ, Weinberger M. Patient treatment adherence: concepts, interventions, and measurement. New York: Psychology Press; 2006.
  19. Hajifaraji M, Dolatkhah N. Gestational diabetes mellitus and associated challenges from the perspective of nutrition science: a review article. J Mazandaran Univ Med Sci 2017; 27(149):202-24. (Persian).
  20. Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metab Disord 2013; 12(1):14.
  21. Nagelkerk J, Reick K, Meengs L. Perceived barriers and effective strategies to diabetes self‐management. J Adv Nurs 2006; 54(2):151-8.
  22. Zare Shahabadi A, Ebrahimi Sadrabadi F. The effect of cognitive factors on treatment of diabetes type II in Yazd. J Clin Psychol Stud 2013; 4(13):1-22.
  23. Barrett HL, Nitert MD, Conwell LS, Callaway LK. Probiotics for preventing gestational diabetes. Cochrane Database Syst Rev 2014; 2:CD009951.  
  24. Afkhami Ardakani M, Rashidi M. Gestational diabetes mellitus. Hormozgan Med J 2007; 11(1):e89060.
  25. Jarald E, Joshi SB, Jain DC. Diabetes Vs herbal medicines. Iran J Pharmacol Ther 2008; 7(1):97-80.
  26. Erfani MN, Shahriari A, Tabandeh MR, Soleimani Z. Study of okra powder (Abelmoscus Esculentus) effects on histology of liver tissue and sero-biochemical parameters in diabetic rats (HFD/STZ). J Shahid Sadoughi Univ Med Sci Health Serv 2016; 24(9):690-705.
  27. Tian ZH, Miao FT, Zhang X, Wang QH, Lei N, Guo LC. Therapeutic effect of okra extract on gestational diabetes mellitus rats induced by streptozotocin. Asian Pac J Trop Med 2015; 8(12):1038-42.
  28. Sabitha V, Ramachandran S, Naveen KR, Panneerselvam K. Antidiabetic and antihyperlipidemic potential of Abelmoschus esculentus (L.) Moench. in streptozotocin-induced diabetic rats. J Pharm Bioallied Sci 2011; 3(3):397-402.
  29. Hosseinzade M, Khadizadeh T, Azhari S. The effects of multiple teaching methods to preventive behavior of postpartum type 2 diabetes in gestational diabetic women attendance to Mashhad health centers. [Master Thesis]. Mashhad: Faculty Nursing and Midwifery Mashhad University of Medical Science; 2015. (Persian).
  30. Chen SL, Tsai JC, Chou KR. Illness perceptions and adherence to therapeutic regimens among patients with hypertension: a structural modeling approach. Int J Nurs Stud 2011; 48(2):235-45.
  31. 31Rajpura J, Nayak R. Medication adherence in a sample of elderly suffering from hypertension: evaluating the influence of illness perceptions, treatment beliefs, and illness burden. Journal of Managed Care Pharmacy. 2014;20(1):58-65.
  32. Shamsi M, Hassanzadeh A, Kachoyee A, Sharifirad G. Influence of walking training on hemoglobin glucosile and fasting blood sugar levels in women with type 2 diabetes. Koomesh 2010; 11(2):99-106. (Persian).
  33. Zakerimoghadam M, Bassampour SH, Rjab A, Faghihzadeh S, Nesari M. Effect of nurse-led telephone follow ups (tele-nursing) on diet adherence among type 2 diabetic patients. J Hayat 2008; 14(2):63-71. (Persian).
  34. Mardani M, Shahraki A. The effect of education based on health belief model of adherence to the diet. Iran J Diabetes Lipid Disord 2010; 9(3):268-75. (Persian).