维生素D辅助门冬胰岛素治疗妊娠期糖尿病的效果及对血糖波动、氧化应激指标的影响

Effect of vitamin D assisted insulin aspart in the treatment of gestational diabetes mellitus and its influences on blood glucose fluctuation and oxidative stress indexes

目的探究维生素D辅助门冬胰岛素治疗妊娠期糖尿病(GDM)的效果及对血糖波动、氧化应激指标的影响。方法选择2019年5月至2021年12月收治的92例GDM患者作为研究对象,根据治疗方案将其分为对照组、观察组,每组46例。对照组接受门冬胰岛素治疗,观察组在对照组基础上加施维生素D辅助治疗。比较两组的治疗效果。结果分娩后,观察组的餐后2 h血糖(2 h PBG)、空腹胰岛素(FINS)水平及稳态模型胰岛素抵抗指数(HOMA-IR)低于对照组(P<0.05)。分娩后,观察组的最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE)、血糖标准差(SD)低于对照组(P<0.05)。分娩后,观察组的超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、总抗氧化能力(T-AOC)水平高于对照组(P<0.05)。观察组的不良妊娠结局总发生率低于对照组(P<0.05)。结论维生素D辅助门冬胰岛素治疗GDM不仅能降低胰岛素抵抗,调节血糖水平,还能控制血糖波动,改善机体氧化应激反应,值得推广。

Objective To explore the effect of vitamin D assisted insulin aspart in the treatment of gestational diabetes mellitus(GDM)and its influences on blood glucose fluctuation and oxidative stress indexes.Methods A total of 92 patients with GDM admitted from May 2019 to December 2021 were selected as the research objects.According to the treatment plan,the patients were divided into control group and observation group,with 46 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 effects of the two groups were compared.Results After delivery,the 2 h postprandial blood glucose(2 h PBG),fasting insulin(FINS)levels and homeostatic model assessment for insulin resistance(HOMA-IR)in the observation group were lower than those in the control group(P<0.05).After delivery,the largest amplitude of glycemic excursions(LAGE),mean amplitude of glycemic excursions(MAGE)and blood glucose standard deviation(SD)in the observation group were lower than those in the control group(P<0.05).After delivery,the levels of superoxide dismutase(SOD),catalase(CAT)and total antioxidative capacity(T-AOC)in the observation group were higher than those in the control group(P<0.05).The total incidence of adverse pregnancy outcomes in the observation group was lower than that in the control group(P<0.05).Conclusion Vitamin D assisted insulin aspart in the treatment of GDM can not only reduce insulin resistance,regulate blood glucose levels,but also control blood glucose fluctuation and improve the body's oxidative stress response,which is worth promoting.