胰岛素泵双波疗法在妊娠糖尿病中的应用

Therapeutic efficiency dual-wave bolus of insulin pump in treatment of gestational diabetes mellitus

目的观察实施动态血糖监测联合胰岛素泵双波疗法在妊娠糖尿病中的疗效研究。方法选取正常孕妇20例及妊娠糖尿病患者46例,将妊娠糖尿病患者分为胰岛素泵常规波治疗组和胰岛素泵双波治疗组,对所有入组孕妇实施动态血糖监测。对比3组平均血糖值、平均血糖漂移幅度、三餐后血糖漂移幅度、低血糖发生率、日内血糖波动最大幅度及妊娠结局。结果与常规波组相比,双波组平均血糖漂移幅度[(2.26±0.94)mmol/L vs(3.52±1.41)mmol/L]、三餐后血糖漂移幅度、日内血糖波动最大幅度[(4.24±0.40)mmol/L vs(6.56±1.32)mmol/L]及剖宫产的发生率(8.7%vs34.78%)显著降低(P<0.05,P<0.01)。结论同胰岛素泵常规波形治疗方案相比,胰岛素泵双波疗法在妊娠糖尿病患者血糖控制的稳定性方面更具优势,可以有效降低剖宫产率。

Objective To determine the curative effect of continuous glucose monitoring combined with dual-wave bolus of insulin pump in the treatment of gestational diabetes mellitus（ GDM）. Methods Twenty normal pregnant women and 46 pregnant women with GDM were selected in the study,and 46 pregnant women with GDM were randomly divided into a normal-wave bolus of insulin pump therapy group and a dual-wave bolus of insulin pump therapy group. All the pregnant women received continuous glucose monitoring. The mean blood glucose（ MBG）,mean amplitude of glycemic excursion（ MAGE）,postprandial glucose excursions（ PPGE）,largest amplitude of glycemic excursions（ LAGE）,frequency of hypoglycemic incidence and pregnancy outcomes were compared. Results Compared with the normal-wave bolus of insulin pump therapy group,the MAGE（ 2. 26 ± 0. 94 vs 3. 52 ± 1. 41 mmol / L）,PPGE,LAGE（ 4. 24 ± 0. 40 vs 6. 56 ± 1. 32 mmol / L）,and caesarean section rate（ 8. 7% vs 34. 78%） were lower in the dual-wave bolus of insulin pump therapy group（ P 0. 05,P 0. 01）. Conclusion Compared with normal-wave bolus of insulin pump therapy,dualwave bolus of insulin pump therapy shows better glucose control stability for the pregnant women with GDM,and can effectively reduce the cesarean section rate.