速效胰岛素类似物诺和锐对初诊妊娠糖尿病治疗的临床评价

Clinical Evaluation of Rapid-acting Insulin Analogue NowRapid Penfill for the Treatment of Newly Diagnosed Gestational Diabetes

目的观察速效胰岛素类似物诺和锐对初诊妊娠糖尿病(GDM)患者的临床疗效。方法选择2020年1—12月接诊的68例初诊GDM患者,随机分为观察组(34例,行速效胰岛素类似物诺和锐治疗)、对照组(34例,行生物合成人胰岛素治疗),评价组间胰岛素功能、血糖相关指标、并发症发生率、新生儿指标、不良妊娠结局。结果 (1)治疗前,组间胰岛素功能[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、C肽]、血糖相关指标[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG)]差异无统计学意义(P>0.05);治疗后,观察组HOMA-IR、HOMA-β、C肽、FPG、HbA1c、2 hPG优于对照组,差异有统计学意义(P<0.05)。(2)在并发症发生率方面,观察组(2.94%)低于对照组(17.65%),差异有统计学意义(P<0.05)。(3)组间新生儿畸形发生率差异无统计学意义(P>0.05),观察组巨大儿(2.94%)、呼吸窘迫(5.88%)、早产儿(2.94%)发生率低于对照组(17.65%、26.47%、20.59%),差异有统计学意义(P<0.05)。(4)观察组羊水过多(0.00%)、妊娠期高血压(2.94%)、剖宫产(11.76%)发生率低于对照组(14.71%、17.65%、35.29%),差异有统计学意义(P<0.05)。结论对初诊GDM患者行速效胰岛素类似物诺和锐治疗,可以改善胰岛素功能,增强血糖控制效果,减少并发症及不良母婴妊娠结局,值得推广。

Objective To observe the clinical efficacy of fast-acting insulin analogue NowRapid Penfill on newly diagnosed gestational diabetes(GDM) patients. Methods A total of 68 newly diagnosed GDM patients who were admitted from January to December 2020 were selected and randomly divided into observation group(34 cases were treated with rapid-acting insulin analogue NowRapid Penfill) and control group(34 cases, undertaking biosynthetic human insulin therapy) to evaluate insulin function, blood glucose-related indicators, complication rates, neonatal indicators, and adverse pregnancy outcomes between groups. Results 1.Before treatment, insulin function between groups [insulin resistance index(HOMA-IR),islet β cell function index(HOMA-β), C peptide], blood glucose related indexes [fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1 c) and 2 h postprandial plasma glucose(2 hPG)] had no statisticallysignificant difference(P>0.05);after treatment, HOMA-IR, HOMA-β, C-peptide, FPG, HbA1 c, 2 hPG in the observation group were better than the control group, the difference was statistically significant(P<0.05). 2.In terms of the incidence of complications, the observation group(2.94%) was lower than the control group(17.65%), the difference was statistically significant(P<0.05). 3.there was no statistically significant difference in the incidence of neonatal abnormalities between the groups(P>0.05), the observation group was huge(2.94%), respiratory distress(5.88%), premature infants(2.94%) were lower than the control group(17.65%,26.47%, 20.59%), the difference was statistically significant(P<0.05).4.the observation group had polyhydramnios(0.00%), the incidence of hypertension during pregnancy(2.94%), and cesarean section(11.76%) were lower than those of the control group(14.71%, 17.65%, 35.29%), the difference was statistically significant(P<0.05). Conclusion The rapid-acting insulin analog NowRapid Penfill treatment for newly diagnosed GDM patients can improve insulin function, enhance the effect of blood glucose control, reduce complications and adverse maternal and infant pregnancy outcomes. It is worthy of promotion.