维生素D辅助双C方案治疗高龄二胎妊娠糖尿病对相关指标及母婴结局的影响

Effect of Vitamin D-assisted Double C Regimen on the Treatment of Elderly Second Trimester Diabetes with Related Indicators and Maternal and Fetal Outcomes

探讨维生素D辅助双C方案治疗高龄二胎妊娠糖尿病对相关指标及母婴结局的影响。根据随机双盲法将2017年2月~2019年3月在我院就诊的124例高龄二胎妊娠糖尿病患者分为对照组(62例)和研究组(62例)。对照组采用双C方案治疗,研究组采用维生素D辅助双C方案治疗,比较两组血糖水平、血糖控制情况、25-羟基维生素D(25-OH-VitD)水平、胰岛素抵抗情况、母婴结局等。治疗后研究组空腹血糖(FPG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbAlc)与对照组相比,差异无统计学意义(P> 0.05)。治疗后研究组胰岛素抵抗指数(HOMA-IR)比对照组低,25-OH-VitD比对照组高,差异均有统计学意义(P <0.05)。研究组胰岛素平均用量、血糖波动幅度、血糖达标时间与对照组相比,差异无统计学意义(P> 0.05)。研究组产妇并发症总发生率比对照组低(12.90%vs 30.65%),新生儿并发症总发生率比对照组低(17.74%vs 40.32%),差异有统计学意义(P <0.05)。对于高龄二胎妊娠糖尿病患者应用维生素D辅助双C方案治疗,可较好控制血糖水平,降低母婴并发症风险,同时有助于减弱胰岛素抵抗情况。

To explore the effect of vitamin D-assisted double C regimen on the treatment of elderly secondary gestational diabetes mellitus with related indicators and maternal and fetal outcomes,using the randomized double-blind method,124 elderly patients with second trimester gestational diabetes who were treated in the author’s hospital from February 2017 to March 2019 were divided into control group( 62 cases) and study group( 62 cases). The control group were treated with double C regimen. The study group were treated with vitamin D-assisted double C regimen. The blood glucose,blood glucose control,25-hydroxyvitamin D,insulin resistance,and maternal and child outcomes were compared between the two groups. After treatment,the fasting blood glucose( FPG),postprandial blood glucose( 2 hPBG),and glycated hemoglobin( Hb Alc) of the study group were not significantly different from those of the control group( P > 0. 05). After treatment,the insulin resistance index( HOMA-IR) of the study group was lower than that of the control group,and 25-OH-VitD was higher than that of the control group,and the differences were statistically significant( P < 0. 05).Compared with the control group,the mean insulin dosage,blood glucose fluctuation range,and blood glucose compliance time in the study group were not significantly different( P > 0. 05). The overall incidence of maternal complications in the study group was lower than that in the control group( 12. 90% vs 30. 65%),and the overall incidence of neonatal complications was lower than that in the control group( 17. 74% vs 40. 32%)( P < 0. 05). For the treatment of elderly patients with second-degree gestational diabetes mellitus with vitamin D-assisted double C regimen,it can better control blood sugar levels,reduce the risk of maternal and child complications,and help to weaken insulin resistance,which is worthy of clinical promotion.