门冬胰岛素特充联合地特胰岛素治疗对妊娠期糖尿病患者胰岛素抵抗及胰岛细胞分泌功能的影响

Effects of Montodorsal Insulin Therapy Combined with Dietinon Insulin Resistance and Secretion of Islet Cells in Patients with Gestational Diabetes Mellitus

目的:探讨门冬胰岛素特充联合地特胰岛素治疗对妊娠期糖尿病患者胰岛素抵抗及胰岛细胞分泌功能的影响。方法:选取2016年4月-2018年10月本院收治的妊娠期糖尿病(GDM)患者112例,按照治疗方式不同分两组,每组各56例。对照组应用诺和灵N治疗,研究组应用门冬胰岛素(诺和锐特充)联合地特胰岛素(诺和平)治疗。观察比较两组GDM患者治疗后血糖达标所需要的平均时间、治疗前后的不同血糖指标及C肽水平、胰岛-β细胞(HOMA-β)功能指数、胰岛素抵抗(HOMA-IR)指数、脂联素及瘦素水平。结果:研究组各项血糖指标达标所需要的平均时间短于对照组(P<0.05);治疗后,研究组各项血糖指标:FPG、2 h PG、HbA1c、03:00 PG水平低于对照组(P<0.05);研究组C肽水平高于对照组(P<0.05);治疗后,研究组HOMA-β功能指数高于对照组(P<0.05);研究组HOMA-IR指数低于对照组(P<0.05);研究组脂联素水平高于对照组(P<0.05);研究组瘦素水平低于对照组(P<0.05)。结论:临床给予GDM患者应用门冬胰岛素特充联合地特胰岛素干预的过程中,能显著提高控制血糖水平的速度及效果,降低GDM患者体内的胰岛素抵抗力、提高胰岛细胞的分泌功能,值得应用及推广。

Objective:To investigate the effects of insulin aspart and dexamethasone on insulin resistance and islet cell secretion in patients with gestational diabetes mellitus.Method:A total of 112 patients with gestational diabetes mellitus(GDM)admitted to our hospital from April 2016 to October 2018 were enrolled.The treatment was divided into two groups,56 cases in each group.The control group was treated with Novo-N,and the study group was treated with insulin aspart(Nuo and RuiTe)plus detemir(NuoHeping).The average time required for blood glucose compliance,the different blood glucose levels and C-peptide levels before and after treatment,the islet-βcell(HOMA-β)function index,insulin resistance(HOMA-IR)index,lipid-linked and leptin levels of the two groups were observed and compared.Result:The average time required for the blood glucose levels of the study group was shorter than that of the control group(P<0.05).After treatment,the blood glucose levels of the study group of FPG,2 h PG,HbA1c,03:00 PG were lower than those of the control group(P<0.05);the C-peptide level of the study group was higher than that of the control group(P<0.05);after treatment,the HOMA-βfunction index of the study group was higher than that of the control group(P<0.05);the HOMAIR index of the study group was lower than that of the control group(P<0.05).The level of adiponectin in the study group was higher than that in the control group(P<0.05).The level of leptin in the study group was lower than that in the control group(P<0.05).Conclusion:In the course of clinical application of GDM patients with insulin aspart and special insulin,it can significantly improve the speed and effect of controlling blood glucose levels,reduce insulin resistance in GDM patients,and improve the secretion function of islet cells.It is worthy of application and promotion.