妊娠期糖尿病控糖治疗中超短效胰岛素联合长效胰岛素对妊娠结局的影响

Effect of Ultra-short-acting Insulin Combined with Long-acting Insulin on Pregnancy Outcome in Glucose Control Therapy for Gestational Diabetes Mellitus

目的探究超短效胰岛素与长效胰岛素联用对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者控糖效果及妊娠结局的影响。方法回顾性选取2023年1月—2024年4月于泉州市第一医院接受诊疗的90例GDM患者的临床资料,按照治疗方法不同分为两组,对照组(n=45)采用长效胰岛素治疗、研究组(n=45)在长效胰岛素基础上联合超短效胰岛素治疗。比较两组糖代谢水平、妊娠结局及治疗效果。结果治疗前,两组糖代谢水平比较,差异无统计学意义(P均>0.05);分娩前,研究组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。两组不良妊娠结局发生率比较,差异无统计学意义(P>0.05)。研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论GDM患者控糖治疗中选择长效与超短效胰岛素联用方式,控糖效果更佳且未增加不良妊娠结局发生风险,临床疗效显著。

Objective To explore the effect of ultra-short-acting insulin combined with long-acting insulin on glu-cose control and pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods The clinical data of 90 patients with GDM who were treated in the Quanzhou First Hospital from January 2023 to April 2024 were retro-spectively selected and divided into two groups according to different treatment methods.The control group(n=45)was treated with long-acting insulin,and the study group(n=45)was treated with ultra-short-acting insulin on the basis of long-acting insulin.The levels of glucose metabolism,pregnancy outcome and treatment effect were compared be-tween the two groups.Results Before treatment,there were no significant differences in the levels of glucose metabo-lism between the two groups(all P>0.05).Before delivery,the levels of fasting blood glucose,2-hour postprandial blood glucose and glycated hemoglobin A1c in the study group were lower than those in the control group,and the dif-ferences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse preg-nancy outcomes between the two groups(P>0.05).The total effective rate of treatment in the study group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion The combination of long-acting and ultra-short-acting insulin in the treatment of GDM patients has better glucose control effect and does not increase the risk of adverse pregnancy outcomes.