妊娠期糖尿病患者行胰岛素单独及联合二甲双胍治疗对患者血糖水平及母婴结局的影响

Effects of Insulin Alone and Combined with Metformin on Blood Glucose Levels and Maternal and Infant Outcomes in Patients with Gestational Dia⁃betes Mellitus

目的探讨妊娠期糖尿病患者行胰岛素单独及联合二甲双胍治疗对患者血糖水平及母婴结局的影响。方法选取2022年1月—2023年2月福建省宁德市霞浦县医院治疗的100例妊娠期糖尿病患者为研究对象,按治疗方法不同分为两组,A组采用胰岛素治疗,B组采用胰岛素+二甲双胍联合治疗,各50例。比较两组血糖水平(餐后2 h血糖、空腹血糖、糖化血红蛋白)、新生儿不良结局、自然分娩率、空腹胰岛素水平。结果治疗后,B组血糖水平均明显低于A组,差异有统计学意义(P均<0.05)。B组新生儿不良结局发生率低于A组,差异有统计学意义(P<0.05)。B组自然分娩率高于A组,差异有统计学意义(P<0.05)。治疗后,B组空腹胰岛素水平低于A组,差异有统计学意义(P<0.05)。结论妊娠期糖尿病患者单独使用胰岛素治疗的效果明显低于联合二甲双胍药物治疗的情况,联合用药能够有效控制患者血糖水平,获得更理想母婴结局。

Objective To investigate the effect of insulin alone and combined with metformin on blood glucose level and maternal and infant outcomes in patients with gestational diabetes mellitus.Methods A total of 100 patients with gestational diabetes mellitus treated in Xiapu County Hospital of Ningde City in Fujian Province from January 2022 to February 2023 were selected as the study objects and divided into two groups according to different treatment meth-ods.Group A was treated with insulin and group B was treated with insulin plus metformin,with 50 cases in each group.Blood glucose levels(2-hour postprandial blood glucose,fasting blood glucose,glycated hemoglobin A1c),neo-natal adverse outcomes,natural delivery rate and fasting insulin levels were compared between the two groups.Results After treatment,the blood glucose levels of group B were significantly lower than those of group A,and the differences were statistically significant(all P<0.05).The incidence of adverse outcomes in group B was lower than that in group A,and the difference was statistically significant(P<0.05).The rate of natural delivery in group B was higher than that in group A,and the difference was statistically significant(P<0.05).After treatment,fasting insulin level in group B was lower than that in group A,and the difference was statistically significant(P<0.05).Conclusion The effect of insulin therapy alone in patients with gestational diabetes mellitus is significantly lower than that of com-bined with metformin.The combination therapy can effectively control the blood glucose level of patients and obtain better maternal and infant outcomes.