二甲双胍与门冬胰岛素联合治疗对妊娠期糖尿病孕妇血糖控制和妊娠结局的影响

Effect of Metformin Combined with Insulin Aspart on Blood Glucose Control and Pregnancy Outcome in Pregnant Women with Gestational Diabetes Mellitus

目的探讨妊娠期糖尿病孕妇应用二甲双胍与门冬胰岛素联合治疗的效果。方法选取2020年1月—2023年11月鄄城马爱云医院收治的92例妊娠期糖尿病孕妇为研究对象,根据治疗方法的不同分为两组,各46例。对照组采用门冬胰岛素治疗,观察组采用二甲双胍与门冬胰岛素联合治疗。比较两组血糖、脂肪因子、炎症因子水平与不良妊娠结局。结果治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于治疗前,且观察组均低于对照组,差异有统计学意义(P均<0.05)。治疗后,两组肿瘤坏死因子-α、白细胞介素-6水平均低于治疗前,且观察组均低于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组瘦素、脂联素水平均优于对照组,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均<0.05)。结论妊娠期糖尿病孕妇实施二甲双胍联合门冬胰岛素治疗,不仅能稳定血糖,还可降低脂肪及炎症因子水平,促进妊娠结局的改善。

Objective To investigate the effect of metformin combined with insulin aspart in pregnant women with gestational diabetes mellitus.Methods A total of 92 pregnant women with gestational diabetes mellitus admitted to Juancheng Ma Aiyun Hospital from January 2020 to November 2023 were selected as the research objects,and they were divided into two groups according to different treatment methods,with 46 cases in each group.The control group was treated with insulin aspart,and the observation group was treated with metformin combined with insulin aspart.The levels of blood glucose,adipokines,inflammatory factors and adverse pregnancy outcomes were compared between the two groups.Results After treatment,the levels of fasting plasma glucose,2-hour postprandial plasma glucose and glycated hemoglobin A1c in the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(all P<0.05).After treatment,the levels of tumor necrosis factor-αand interleukin-6 in the two groups were lower than those before treatment,and those in the observation group were lower than the control group,the differences were statistically significant(all P<0.05).After treatment,the levels of leptin and adiponectin in the observation group were better than those in the control group,and the differences were statistically significant(all P<0.05).The incidence of adverse pregnancy outcomes in the observation group were lower than that in the control group,and the differences were statistically significant(all P<0.05).Conclusion Metformin combined with insulin aspart in pregnant women with gestational diabetes mellitus can not only stabilize blood glucose,but also reduce the levels of fat and inflammatory factors,and promote the improvement of pregnancy outcome.