176例妊娠糖尿病患者的饮食与胰岛素治疗框架思路构建

176 Cases of Gestational Diabetes Mellitus Patients Diet and Insulin Therapy Framework

目的分析妊娠期糖尿病(gestational diabetes mellitus,GDM)特点,评价饮食疗法与胰岛素治疗对GDM患者妊娠结局的影响。方法选择该院2020年1月—2021年5月期间收治的352例GDM患者,按照随机数表法分组。对照组176例,采取门冬胰岛素联合地特胰岛素治疗。观察组176例,采取胰岛素治疗配合饮食疗法。比较两组GDM患者的治疗情况,包括治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白水平、血糖达标时间、胰岛素用量以及不良妊娠结局发生情况。结果治疗后两组GDM患者的空腹血糖、餐后2 h血糖、糖化血红蛋白水平较治疗前均下降,且观察组患者血糖水平低于对照组,差异有统计学意义(P<0.05);与对照组比较,观察组患者血糖达标时间更短、胰岛素用量更少,差异有统计学意义(P<0.05);观察组患者低血糖发生率、剖宫产率、早产率均明显低于对照组,差异有统计学意义(P<0.05)。结论血糖监测、运动干预基础上,予以GDM患者饮食疗法与胰岛素治疗,有助于控制患者血糖,改善患者妊娠结局。

Objective To analyze the characteristics of gestational diabetes mellitus(GDM),and to evaluate the influence of dietary therapy and insulin therapy of pregnancy outcome on the GDM Patients.Methods 352 patients with GDM admitted to the hospital from January 2020 to May 2021 were selected and grouped according to the random number table method.176 cases were treated with insulin aspart combined with insulin detemir as the control group.observation group,176 cases were treated with insulin therapy combined with diet therapy as the observation group.The treatment status of the two groups of GDM patients was compared,including fasting blood glucose before and after treatment,2 h blood glucose after meal,glycosylated hemoglobin level,blood glucose reaching target time,insulin dosage,and occurrence of adverse pregnancy outcomes.Results After treatment,the fasting blood glucose,blood glucose and glycosylated hemoglobin levels of the two groups of GDM patients was decreased than before treatment,the blood glucose level of patients in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Compared with the control group,patients in the observation group had shorter time to reach the standard of blood glucose and less insulin consumption,and the difference was statistically significant(P<0.05).The incidence of hypoglycemia,cesarean section,and premature delivery in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion On the basis of blood glucose monitoring and exercise intervention,diet therapy and insulin therapy for GDM patients can help control blood glucose and improve the pregnancy outcome.