门冬胰岛素联合个体化医学营养疗法对妊娠期糖尿病患者的血糖控制效果及母婴结局的影响

Effect of Insulin Aspart Combined with Individualized Medical Nutrition Therapy on Blood Glucose Control in Patients with Gestational Diabetes and on Maternal and Infant Outcomes

目的探讨门冬胰岛素联合个体化医学营养疗法对妊娠期糖尿病患者的效果观察.方法选取我院2021年1月—2022年1月收治的70例妊娠期糖尿病患者为研究对象,按照随机数字表法将其分为对照组与观察组,每组35例.对照组采用门冬胰岛素治疗,观察组采用门冬胰岛素联合个体化医学营养疗法,两组均连续治疗3个月.比较两组患者的临床疗效、血糖指标[空腹血糖(FPG)、餐后2h血糖(PBG)、糖化血红蛋白(HbAlc)]、血脂指标[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和三酰甘油(TG)]及母婴结局.结果观察组的治疗总有效率为94.29%,高于对照组的74.29%,差异有统计学意义(P<0.05).治疗后,两组的FPG、PBG、HbAlc、TC、LDL-C和TG水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05).观察组巨大儿、早产、剖宫产、新生儿低血糖和胎儿窘迫的总发生率为14.29%,低于对照组的37.14%,差异有统计学意义(P<0.05).结论门冬胰岛素联合个体化医学营养疗法可改善妊娠期糖尿病患者糖脂代谢,减少母婴并发症.

Objective To study the effect of insulin aspart combined with individualized medical nutrition therapy on patients with gestational diabetes.Methods 70 patients with gestational diabetes mellitus admitted to our hospital from January 2021 to January 2022 were selected as the study objects,and were divided into a control group and an observation group according to random number table method,with 35 cases in each group.The control group was treated with insulin aspartate,and the observation group was treated with insulin aspartate combined with individualized medical nutrition therapy.Both groups were treated continuously for 3 months.The clinical efficacy,blood glucose indexes[fasting blood glucose(FPG),2 h postmeal blood glucose(PBG),glycated hemoglobin(HbAlc)],blood lipid indexes[total cholesterol(TC),low density lipoprotein(LDL-C)and triacylglycerol(TG)]and maternal and infant outcomes were compared between the two groups.Results The total effective rate of the observation group was 94.29%,higher than 74.29%of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of FPG,PBG,HbAlc,TC,LDL-C and TG in both groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).The total incidence of macrosomia,premature delivery,cesarean section,neonatal hypoglycemia and fetal distress in the observation group was 14.29%,lower than 37.14%in the control group,and the difference was statistically significant(P<0.05).Conclusion Menthol insulin combined with individualized medical nutritional therapy can improve glucose-lipid metabolism in gestational diabetes mellitus patients and reduce maternal and infant complications.