联合胰岛素方案对妊娠合并糖尿病患者降糖效果及安全性的影响

Effect of combined insulin regimen on hypoglycemic effect and safety in patients with gestational diabetes mellitus

目的探讨联合胰岛素方案对妊娠合并糖尿病患者降糖效果及安全性的影响。方法选取2017年1月至2019年1月该院收治的妊娠合并糖尿病患者120例,采用随机数字表法分为研究组和对照组,每组60例。对照组给予常规人胰岛素治疗,研究组给予门冬胰岛素联合地特胰岛素治疗。观察两组患者治疗前后血糖情况(包括空腹血糖、餐后2 h血糖、糖化血红蛋白等)、血糖达标时间等。比较两组患者母婴分娩结果(母婴低血糖、剖宫产、新生儿高胆红素血症发生情况等)。结果两组患者治疗后空腹血糖、餐后2 h血糖、糖化血红蛋白水平均明显降低,且研究组患者明显低于对照组,研究组患者餐后2 h血糖达标时间、空腹血糖达标时间、母婴低血糖发生率均明显低于对照组,差异均有统计学意义(P<0.05);两组患者剖宫产、新生儿高胆红素血症发生率比较,差异均无统计学意义(P>0.05)。结论地特胰岛素联合门冬胰岛素能显著提高血糖控制效果,降低母婴低血糖发生率,同时不会对患者和胎儿产生显著影响。

Objective To investigate the effect of combined insulin regimen on hypoglycemic effect and safety of patients with gestational diabetes mellitus.Methods A total of 120 patients with gestational diabetes mellitus in our hospital were divided into study group and control group according to the method of random number table.The control group was given routine human insulin therapy.The group was treated with insulin aspartate combined with insulin detritus.After 2 weeks of treatment,the blood glucose before and after treatment,the incidence of hypoglycemia,glycosylated hemoglobin and the time of blood glucose reaching the standard were detected,and the blood glucose and fasting blood glucose were monitored 2 h after meal.The occurrence of adverse events in the two groups was recorded.Comparison of maternal and infant delivery results between the two groups.Results After treatment The levels of fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the study group were significantly lower than those in the control group(P<0.05);the postprandial blood glucose meeting time and fasting blood glucose meeting time in the study group were significantly lower than those in the control group(P<0.05);the incidence of cesarean section and neonatal hyperbilirubinemia and neonatal hyperbilirubinemia between the two groups(P<0.05).Conclusion Dieter insulin combined with insulin aspartate can significantly improve the effect of blood glucose control,reduce the incidence of maternal and infant hypoglycemia,while not to patients and patients the fetus has a significant effect.