门冬胰岛素联合地特胰岛素对妊娠期糖尿病的临床疗效

Clinical Effect of Aspartic Insulin Combined with Insulin Detemir on Gestational Diabetes Mellitus

目的:比较门冬胰岛素与地特胰岛素联合与单用门冬胰岛素治疗妊娠糖尿病(gestational diabetes mellitus,GDM)的临床效果及对母婴结局的影响。方法:选取2016年1月~2017年9月就诊于温州中西医结合医院,诊断为妊娠期糖尿病的患者90例,将其随机分为观察组和对照组,各45例,对照组每日三餐前予以皮下注射门冬胰岛,观察组在对照组的基础上,每日晚间联合注射地特胰岛素,分析比较两组患者血糖达标所需时间及治疗两周后血糖达标率;记录低血糖、严重低血糖的发生情况;另外,分析比较两组的母婴结局。结果:观察组患者血糖达标时间明显较对照组缩短(P<0.05),连续治疗两周后,观察组患者血糖达标率也较对照组明显增加(P<0.05);治疗期间观察组患者低血糖及严重低血糖的发生率较对照组明显较少(P<0.05)。观察组孕妇早产、产褥感染以及巨大儿的发生率均明显低于对照组(P<0.05)。结论:门冬胰岛素基础上联用地特胰岛素能更安全、有效地控制妊娠期血糖,有助于妊娠糖尿病的管理。

Objective:To compare the clinical effect of aspartic insulin compared with detemir insulin and single aspartic insulin in the treatment of gestational diabetes and their effect on the outcome of mother and child.Methods:From January 2016 to September2017,90 patients with GDM were selected and randomly divided into observation group and control group,with 45 cases in each group.The control group was subcutaneously injected with aspartic islet before meals,and the observation group was given the injection of insulin detemir nightly based on the control group.The time required for blood glucose control and the standard rate of blood glucose after two weeks of treatment were compared and analyzed between the two groups,and the occurrence of hypoglycemia and severe hypoglycemia was recorded.In addition,the influence of the maternalinfant outcomes were analyzed and compared.Results:The blood glucose standard time of the observation group was significantly shorter than that of the control group(P<0.05).After two weeks of treatment,the blood glucose compliance rate of the observation group was significantly higher than that of the control group(P<0.05).During the treatment,the incidence of hypoglycemia and severe hypoglycemia in the observation group were significantly less than those in the control group(P<0.05).The incidence of premature labor,puerperal infection,and the proportion of fetal macrosomia in the observation group were lower than those in the control group(P<0.05).Conclusion:Insulin aspart combined with insulin detemir can safely and effectively control blood glucose during pregnancy,and contribute to the management of GDM.