维生素D联合门冬胰岛素对妊娠期糖尿病患者糖脂代谢、胰岛素抵抗的影响

Effects of Vitamin D Combined with Insulin Aspart on Glucose and Lipid Metabolism and Insulin Resistance in Patients with Gestational Diabetes Mellitus

目的研究维生素D联合门冬胰岛素对妊娠期糖尿病患者糖脂代谢、胰岛素抵抗的影响。方法选取2020年1月-2021年1月在我院诊治的62例妊娠期糖尿病患者为研究对象,采用随机数字表法分为对照组和观察组,各31例。对照组采用门冬胰岛素治疗,观察组在对照组基础上应用维生素D治疗,比较两组临床疗效、血糖指标、血脂指标、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)以及不良妊娠结局。结果观察组治疗总有效率为90.32%,高于对照组的80.65%(P<0.05);两组治疗后空腹血糖(FPG)、餐后2 h血糖(2 hPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)均低于治疗前,且观察组低于对照组(P<0.05);两组治疗后FINS、HOMA-IR均小于治疗前,且观察组小于对照组(P<0.05);观察组不良妊娠结局发生率为6.45%,低于对照组的16.13%(P<0.05)。结论维生素D联合门冬胰岛素可提高妊娠期糖尿病疗效,改善糖脂代谢指标,降低胰岛素抵抗,且可降低不良妊娠结局发生率,是一种有效、可行的联合用药治疗方案。

Objective To study the effect of vitamin D combined with insulin aspart on glucose and lipid metabolism and insulin resistance in patients with gestational diabetes mellitus.Methods A total of 62 patients with gestational diabetes mellitus diagnosed and treated in our hospital from January 2020 to January 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 31 cases in each group.The control group was treated with insulin aspart,and the observation group was treated with vitamin D on the basis of the control group.The therapeutic effect,blood glucose index,blood lipid index,fasting insulin(FINS),insulin resistance index(HOMA-IR)and adverse pregnancy outcomes were compared between the two groups.Results The total effective rate of the observation group was 90.32%,which was higher than 80.65%of the control group(P<0.05).After treatment,fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL)in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).After treatment,FINS and HOMA-IR in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).The incidence of adverse pregnancy outcomes in the observation group was 6.45%,which was lower than 16.13%in the control group(P<0.05).Conclusion Vitamin D combined with insulin aspart can improve the efficacy of gestational diabetes mellitus,improve glucose and lipid metabolism indicators,reduce insulin resistance,and reduce the incidence of adverse pregnancy outcomes.It is an effective and feasible combination therapy.