地特胰岛素联合门冬胰岛素及运动处方对妊娠期糖尿病患者血糖水平的影响

Effect of Insulin Detemir Combined with Insulin Aspart and Exercise Pre⁃scription on Blood Glucose Level in Gestational Diabetes Mellitus Patients

目的分析在运动处方基础上联合地特胰岛素+门冬胰岛素治疗对妊娠期糖尿病的干预作用。方法回顾性选取2022年9月—2023年9月福建省宁化县总医院妇产科收治的94例妊娠期糖尿病患者的临床资料,依照干预方法不同将患者分为两组,各47例。全部患者予以运动处方干预,在此基础上对照组采取精蛋白人胰岛素+门冬胰岛素方案治疗,观察组采取地特胰岛素+门冬胰岛素方案治疗。比较两组血糖指标水平、胰岛功能及不良妊娠结局发生率。结果干预后,与干预前相比,两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均降低,且观察组低于对照组,差异有统计学意义(P均<0.05)。干预后,与干预前相比,两组胰岛β细胞功能指数均升高,胰岛素抵抗指数均降低,且观察组优于对照组,差异有统计学意义(P均<0.05)。观察组不良妊娠结局发生率低于对照组,差异有统计学意义(P<0.05)。结论在运动处方基础上联合地特胰岛素+门冬胰岛素治疗,可更有效控制妊娠期糖尿病患者的血糖水平,改善其胰岛功能,降低不良妊娠结局发生风险。

Objective To analyze the intervention effect of insulin detemir+insulin aspart on gestational diabetes mel⁃litus on the basis of exercise prescription.Methods The clinical data of 94 patients with gestational diabetes mellitus admitted to the Department of Obstetrics and Gynecology of Ninghua County General Hospital of Fujian Province from September 2022 to September 2023 were retrospectively selected.The patients were divided into two groups according to different intervention methods,with 47 cases in each group.All patients were given exercise prescription interven⁃tion.On this basis,the control group was treated with protamine human insulin+insulin aspart,and the observation group was treated with insulin detemir+insulin aspart.The levels of blood glucose indexes,islet function and inci⁃dence of adverse pregnancy outcomes were compared between the two groups.Results After intervention,compared with before intervention,the levels of fasting plasma glucose,2-hour postprandial plasma glucose and glycated hemo⁃globin A1c in the two groups decreased,and those in the observation group were lower than the control group,the dif⁃ferences were statistically significant(all P<0.05).After intervention,compared with before intervention,the homeo⁃static model assessment-βof the two groups increased,the homeostatic model assessment-IR decreased,and the ob⁃servation group was better than the control group,the differences were statistically significant(both P<0.05).The inci⁃dence of adverse pregnancy outcomes in the observation group was lower than that in the control group,and the differ⁃ence was statistically significant(P<0.05).Conclusion The combination of exercise prescription and insulin detemir and insulin aspart can effectively control the blood glucose levels,improve the islet function and reduce the risk of ad⁃verse pregnancy outcomes in patients with gestational diabetes mellitus.