Effects of Cognitive Behavioral Therapy for Diet on Postprandial Glucose and Pregnancy Outcomes in Gestational Diabetes Mellitus: Multicenter Randomized Controlled Trial

Abstract

Abstract BackgroundGestational diabetes mellitus (GDM) is associated with an elevated risk of adverse maternal and neonatal outcomes. Dietary management is a cornerstone of GDM treatment due to its beneficial effects on metabolic control. However, suboptimal adherence to dietary recommendations has diminished its potential benefits in achieving optimal glycemic outcomes. Cognitive behavioral therapy (CBT)–based interventions have emerged as a promising approach to enhance dietary compliance and glycemic control in patients with GDM. ObjectiveThis study aims to investigate the effects of a CBT-based digital dietary intervention on glycemic control and pregnancy outcomes in patients with GDM. MethodsThe intervention group received standard care plus a digital dietary intervention based on CBT principles, delivered via a customized WeChat (Tencent Inc) mini program. This intervention included structured dietary education and behavioral strategies focused on appropriate food selection and meal sequencing. The control group received standard care alone. The primary outcome was the glycemic qualification rate, and secondary outcomes included fasting blood glucose, postprandial blood glucose (PBG), General Self-Efficacy Scale scores, and incidence of macrosomia. Self-monitored blood glucose data were collected and analyzed at biweekly follow-up visits from enrollment until delivery. ResultsOf the 200 participants, 171 completed the study. The average age was 31.2 (SD 4) years, and the average gestational age at enrollment was 26.3 (SD 1.6) weeks. Baseline HbA1cP=.PPPPPP ConclusionsThe findings of this randomized controlled trial suggest that a CBT-based digital dietary intervention can significantly enhance glycemic control, particularly PBG levels, and may contribute to improved pregnancy outcomes with a reduced incidence of macrosomia in women with GDM.