胰岛素不同给药方式在治疗高龄妊娠期糖尿病中的临床价值探讨

Clinical Value Discussion of Different Insulin Administration Modes in Treatment of Elderly Pregnant Diabetes

目的探讨胰岛素不同给药方式在改善高龄妊娠期糖尿病患者血糖代谢、胰岛素抵抗程度及机体炎症反应中的应用价值。方法选取2020年6月—2021年7月本院收治的80例高龄妊娠期糖尿病患者为研究对象,将其随机划分为A组和B组,每组40例。分别给予两组不同的治疗方案并均完成1周的治疗(将门冬胰岛素注射液应用于两组中,此外将胰岛素皮下注射方案应用于A组,将胰岛素皮下持续泵注方案应用于B组)。比较不同组间及组内的指标变化[血糖控制情况(治疗期间)及血糖水平、胰岛素抵抗程度及血清炎症因子水平(治疗前、治疗4周后)]。结果B组治疗期间的血糖达标时间更短(相较于A组),组间差异有统计学意义(P<0.05)。胰岛素用量、低血糖发生率均更低(相较于A组),组间差异有统计学意义(P<0.05)。两组治疗4周后的血清各项指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPBG)、空腹胰岛素(F-INS)、空腹C肽(F-CP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及胰岛素抵抗指数(HOMA-IR)]均更低(相较于治疗前),且B组更低(相较于A组),组间差异有统计学意义(P<0.05)。两组治疗4周后的胰岛素敏感指数(ISI)及血清脂联素(APN)水平均更高(相较于治疗前),B组更高(相较于A组),组间差异有统计学意义(P<0.05)。结论与皮下注射胰岛素相比,皮下持续泵注胰岛素可有效降低患者血糖水平及胰岛素抵抗程度,改善患者血糖控制情况,降低机体炎症反应,治疗效果较好,具有较好的临床应用价值。

Objective To explore application value of different insulin administration methods in improving blood glucose metabolism,insulin resistance and body inflammation of elderly pregnant women with diabetes.Methods The paper chose 80 elderly pregnant patients with diabetes in our hospital from June 2020 to July 2021 as research objects,and divided them into group A and group B randomly,with 40 cases in each group,treated with two different treatment schemes,completed in one week(with insulin aspart injection for two groups,in addition,group A was treated with subcutaneous insulin injection plan,and group B with subcutaneous continuous pump insulin scheme).Changes in indicators between different groups were compared,including blood glucose control(during treatment)and blood glucose levels,insulin resistance,and serum inflammatory factor levels(before treatment,4 weeks after treatment).Results Time for blood glucose to reach standard during treatment in group B was shorter than group A,with P<0.05.Insulin dosage and incidence of hypoglycemia were lower than group A,with P<0.05.Serum indicators after 4 weeks of treatment in two groups were lower than before treatment,including glycated hemoglobin(HbA1c),fasting blood glucose(FPG),2-hour postprandial blood glucose(2-hour PBG),fasting insulin(F-INS),fasting C-peptide(F-CP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),levels and insulin resistance index(HOMA-IR).Those of group B were lower than group A,with P<0.05.After 4 weeks of treatment,insulin sensitivity index(ISI)and serum adiponectin(APN)levels were higher in both groups than before treatment,those in group B were higher than group A,with P<0.05.Conclusion Compared with subcutaneous injection of insulin,continuous subcutaneous pumping of insulin can reduce blood glucose levels and insulin resistance effectively,improve blood glucose control,reduce body inflammatory response of patients,which has good clinical application value.