胰岛素泵双波疗法治疗妊娠期糖尿病患者的效果观察

Effect of insulin pump double wave therapy on gestational diabetes mellitus

目的:探讨妊娠期糖尿病(GDM)患者经胰岛素泵双波疗法治疗的效果。方法:选取某院收治的GDM患者91例,采用随机数字表法分为2组。常规波组(45例)予以胰岛素泵常规波治疗,双波疗法组(46例)予以胰岛素泵双波疗法。比较2组患者治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)]、餐后血糖漂移幅度[早餐后血糖漂移幅度(BPPGE)、午餐后血糖漂移幅度(LPPGE)、晚餐后血糖漂移幅度(DPPGE)]、血糖达标时间、胰岛素用量、低血糖发生率、脂肪因子[视黄醇结合蛋白4(RBP4)、脂肪酸结合蛋白质4(FABP4)、脂联素(APN)]水平及不良妊娠结局。结果:治疗28 d后,双波疗法组FPG、2 hPG低于常规波组,BPPGE、LPPGE、DPPGE小于常规波组(P<0.05);双波疗法组血糖达标时间短于常规波组,血清RBP4、FABP4水平低于常规波组,血清APN水平高于常规波组,差异均具有统计学意义(P<0.05);随访至分娩结束,2组患者不良妊娠结局发生率比较差异无统计学意义(P>0.05)。结论:胰岛素泵双波疗法治疗GDM,有助于调节脂肪因子水平,控制血糖水平,减小餐后血糖漂移幅度,缩短血糖达标时间。

Objective:To investigate the effect of insulin pump double wave therapy on gestational diabetes mellitus(GDM).Methods:91 GDM patients in a hospital were randomly divided into two groups.The conventional wave group(45 cases)was given insulin pump conventional wave therapy,and the double wave therapy group(46 cases)was treated with insulin pump double wave therapy.Blood glucose indexes before and after treatment(FPG and 2hPG),postprandial blood glucose excursion(BPPGE after breakfast,LPPGE after lunch,DPPGE after dinner),the time to reach the standard of blood glucose,insulin dosage,incidence of hypoglycemia,adipokines(RBP4),fatty acid binding protein 4(FABP4),adiponectin(APN)and adverse pregnancy outcomes were measured.Results:28 days after the treatment,FPG and 2hPG in the double wave therapy group were lower than those in the conventional wave group(P<0.05);bppge,lppge and dppge in the double wave therapy group were lower than those in the conventional wave group(P<0.05);the time to reach the standard of blood glucose of the double wave therapy group was shorter than that of the conventional wave group(P<0.05);the levels of RBP4 and FABP4 in serum were lower than those in the conventional wave group,and serum APN level was higher than that in the conventional wave group(P<0.05).There was no significant difference in the incidence of adverse pregnancy outcomes between the two groups by the end of the follow-up(P>0.05).Conclusion:Insulin pump double wave therapy in the treatment of GDM is helpful to regulate the level of adipokines,control the blood glucose level,reduce the range of postprandial blood glucose excursion,and shorten the time of blood glucose reaching the standard.