妊娠期糖尿病患者应用盐酸二甲双胍联合门冬胰岛素的效果研究

Effect of Metformin Hydrochloride Combined with Insulin Aspartate in Patients with Gestational Diabetes Mellitus

目的:探究妊娠期糖尿病(GDM)患者应用盐酸二甲双胍联合门冬胰岛素的效果。方法:从2021年9月至2023年8月间郑州大学第一附属医院产科收治的GDM患者中择取80例展开研究,按随机数字表法划分为对照组与观察组,各40例。对照组单独应用门冬胰岛素治疗,观察组则予以盐酸二甲双胍联合门冬胰岛素的给药方式治疗,比较两组患者的临床治疗效果、血糖指标水平、胰岛素指标水平和不良妊娠结局。结果:治疗前,两组患者的各项血糖、胰岛素指标水平比较,差异均无统计学意义(P>0.05);治疗1个月后,观察组患者的空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(Homa-IR)水平低于对照组,空腹胰岛素(FINS)、胰岛β细胞功能指数(Homa-β)水平则高于对照组,差异均具有统计学意义(P<0.05)。比较两组的不良妊娠结局发生率,观察组低于对照组,差异均具有统计学意义(P<0.05)。结论:对于经过饮食+运动控制后,血糖的水平仍然没有达到良好控制效果的GDM患者,给予盐酸二甲双胍联合门冬胰岛素治疗,不但能将患者的血糖控制在更低的水平,改善胰岛的功能,而且还能减少不良妊娠结局的发生。

Objective To investigate the effect of metformin hydrochloride combined with insulin aspartate in patients with gestational diabetes mellitus(GDM).Methods A total of 80 GDM patients admitted to the Obstetrics Department of the First Affiliated Hospital of Zhengzhou University from September 2021 to August 2023 were selected for this study and divided into a control group and an observation group according to random number table method,with 40 cases in each group.The control group was treated with insulin aspartate alone,and the observation group was treated with metformin hydrochloride combined with insulin aspartate.The clinical therapeutic effect,blood glucose index level,insulin index level and adverse pregnancy outcome of the two groups were compared.Results Before treatment,there was no statistical significance in the levels of blood glucose and insulin between the two groups(P>0.05).After 1 month of treatment,the levels of fasting blood glucose(FPG),2h postprandial blood glucose(2h PG),glycosylated hemoglobin(HbA1c)and insulin resistance index(Homa-IR)in the observation group were lower than those in the control group,while the levels of fasting insulin(FINS)and homeostasis model assessment of function index(Homa–β)were higher than those in the control group,with statistical significance(P<0.05).The incidence of adverse pregnancy outcome between the two groups was compared,and the index of the observation group was lower than that 4 the control group,with statistical significance(P<0.05).Conclusion For GDM patients whose blood sugar level has not achieved a good control effect after diet and exercise control,metformin hydrochloride combined with insulin aspartate therapy can not only control the blood sugar level of the patients at a lower level,improve the function of the islets,but also reduce the occurrence of adverse pregnancy outcomes.