Gene therapy for type 1 diabetes mellitus in rats by gastrointestinal administration of chitosan nanoparticles containing human insulin gene

AIM:To study the expression of human insulin gene in gastrointestinal tracts of diabetic rats. METHODS: pCMV.Ins, an expression plasmid of the human insulin gene, wrapped with chitosan nanoparticles, was transfected to the diabetic rats through lavage and coloclysis, respectively. Fasting blood glucose and plasma insulin levels were measured for 7 d. Reverse transcription polymerase chain reaction (RT-PCR) analysis and Western blot analysis were performed to confirm the expression of human insulin gene. RESULTS: Compared with the control group, the fasting blood glucose levels in the lavage and coloclysis groups were decreased significantly in 4 d (5.63 ± 0.48 mmol/L and 5.07 ± 0.37 mmol/L vs 22.12 ± 1.31 mmol/L, respectively, P < 0.01), while the plasma insulin levels were much higher (32.26 ± 1.81 μIU/mL and 32.79 ± 1.84 μIU/mL vs 14.23 ± 1.38 μIU/mL, respectively, P < 0.01). The human insulin gene mRNA and human insulin were only detected in the lavage and coloclysis groups. CONCLUSION: Human insulin gene wrapped with chitosan nanoparticles can be successfully transfected to rats through gastrointestinal tract, indicating that chitosan is a promising non-viral vector.

Human insulin-like growth factor 1-transfected umbilical cord blood neural stem cell transplantation improves hypoxic-ischemic brain injury

Human insulin-like growth factor 1-transfected umbilical cord blood neural stem cells were transplanted into a hypoxic-ischemic neonatal rat model via the tail vein. BrdU-positive cells at day 7 post-transplantation, as well as nestin- and neuron specific enolase-positive cells at day 14 were increased compared with those of the single neural stem cell transplantation group. In addition, the proportion of neuronal differentiation was enhanced. The genetically modified cell-transplanted rats exhibited enhanced performance in correctly crossing a Y-maze and climbing an angled slope compared with those of the single neural stem cell transplantation group. These results showed that human insulin-like growth factor 1-transfected neural stem cell transplantation promotes the recovery of the leaming, memory and motor functions in hypoxic-ischemic rats.

Expression of CTB-human Insulin(BA) Fusion Protein in Gynostemma Pentapyhllum Makino Callus Cells and Its Hypoglycemic Effect in Mice

The plant expression vector of choleratoxin B subunit（CTB）-human insulin（BA） fusion protein pBI121/（CTB-BA） was constructed first and then the Gynostemma Pentapyhllum Makino callus cell line that could express CTB-human insulin fusion protein was constructed and its hypoglycemic effect was evaluated in mice. The plant expression vector pBl 121/（CTB-BA） was digested with both BamI and SacI. Agrobacterium tumerfaciens strain LBA4404 was transformed with previously constructed recombinant plasmid pBI121/（CTB-BA） via the freeze thawing method, then CTB-BA gene was integrated to G Pentapyhllum Makino callus cells by co-culturing the cells with the transformed LBA4404 strain. The transformed G Pentapyhllum Makino callus cells were identified by DNA sequence assey and RT-PCR. The expressed product was identified by western-blot and its amount was tested by ELISA kit and its blood sugar decreasing effect was tested in mice. The sequences of synthetic CTB and human insulin genes（BA） were completely identical to those designed. Restriction map proved that the length of gene fragment in- serted into expression vector pBI121 was consistent with that expected. The sequence of genomic DNA of expressed product was completely identical to that designed. The result of RT-PCR was consistent with that expected. The expressed product showed a specific band with a relative molecular mass of 17000 by Western-blot. The human insulin expression amount was 6.03 μIU/mL according to the ELISA result. The animal test showed that only the G Pentapyhllum Makino callus cell line itself showed activity in decreasing the blood sugar of mice, however, the activity of the transformed G Pentapyhllum Makino callus cells was much higher, The plant expression vector pBI121/（CTB-BA） was constructed and expressed in the G Pentapyhllum Makino callus cells successfully for the first time. The trans- formed G Pentapyhllum Makino callus cells showed high activity in decreasing the blood sugar of mice. This study developed a new way for the development of oral administration insulin.

Assessment of a Case of Immediate-Type Allergy against Human Insulin in a Type 2 Diabetic Patient and Allergic Reactions to Human Insulin in Japan

We report a 64-year-old female patient with an insulin allergy. She was treated with a combination of oral antihistamines, topical hydrocortisone cream, and moisturizing agents, which resulted in the improvement of eczema and intense pruritus. To evaluate insulin allergy, intradermal skin tests were performed with several insulin agents for clinical use and 0.9% NaCl. Skin testing with semisynthetic human insulin resulted in local, immediate skin reactions such as itchy erythema and wheals. Furthermore, we analyzed our case and 25 Japanese cases of insulin allergy previously reported in the literature as far as we know. Interestingly, the number of male patients was approximately two times higher than that of female, and the insulin-specific IgE antibody test was positive in 21 patients. We should keep the possibility of human insulin allergy in mind and prepare for it when initiating human insulin therapy.

A secretory function of human insulin-producing cells in vivo

BACKGROUND: Mesenchymal stem cells derived from human umbilical cord blood (UCB-MSCs) have good research and application prospects in the treatment of diabetes. We once induced UCB-MSCs to differentiate into insulin-producing cells (IPCs) in vitro, but we did not know the functions of these cells in vivo. The aim of this study was to assess the functional effects of IPCs on insulin secretion and their role in the treatment of diabetes in vivo. METHODS: UCB-MSCs were induced to IPCs by an inducing protocol with extracellular matrix gel. BALB/C nude mice were made hyperglycemic by intraperitoneal injection of streptozotocin. The diabetic mice were transplanted with 1x10(7) IPCs under the renal capsule or with phosphate-buffered saline as a control. After transplantation, the grafts were analyzed by immunocytochemistry for the expression of human insulin; the serum human insulin levels were measured; and blood glucose and body weight status were monitored. RESULTS: Immunofluorescence showed that numerous IPCs under the kidney capsule were insulin-positive. On day 14 after transplantation, the serum human insulin level of the treatment group (n=9) averaged 0.44 +/- 0.12 mU/L, which was higher than that of the control group (n=9) that did not express insulin (t=10.842, P<0.05). The diabetic mice remained hyperglycemic and kept losing body weight after IPC transplantation, and there was no significant difference in the control group. CONCLUSION: IPCs differentiated from UCB-MSCs generate human insulin in diabetic mice, but more research is needed to make further use of them to regulate hyperglycemia and body weight in vivo. (Hepatobiliary Pancreat Dis Int 2009; 8: 255-260)

Effects of Human Insulin Gene Transfection on the Adipogenic Differentiation of Human Umbilical Cord Mesenchymal Stem Cells in Silk Fibroin Scaffolds <i>in Vitro</i>

The resorption of the transplanted fat over time limited the use of autologous fat for the reconstruction of soft tissue defect. Tissue engineering (TE) adipose with silk fibroin scaffold could be a promising substitute for soft tissue filling. In this study, we try to develop a tissue engineering adipose in vitro by seeding silk fibroin scaffold with human umbilical cord mesenchymal stem cells (hUCMSCs) after transfected with recombinant human insulin gene lentivirus. Our aim was to observe the effects of the insulin gene transfection on the adipogenesis of hUCMSCs when cultured with silk fibroin scaffolds. The hUCMSCs infected with recombinant lentiviral pLenti6.3-insulin-IRES-EGFP were seeded on silk fibroin scaffolds and cultured in adipogenic differentiation medium for 5 - 7 days. The expression of adipogenic gene PPARγ-2 was tested by RT-PCR after 7 days culture of adipogenic induction. The accumulation of cytoplasmic droplets of neutral lipids was assessed by Oil Red O staining. The RNA and protein expression of transfected insulin gene in hUCMSCs were detected by QPCR and western blot. The effect of recombinant lentivirus transfection on the growth and proliferation of hUCMSCs was observed by MTT test. We observed that the 2-ΔΔCt value of insulin gene expression of hUCMSCs in the transfected group was 300.25 times higher than that in the untransfected group. The western blot showed that a positive band was discerned at the site of a relative molecular mass of 8 × 103 Dalton in transfected group. After adipogenic culture for 7 days, under the fluorescent inverted phase-contrast microscope, after Oil Red O staining, a lot of adipocytes appeared in silk fibroin scaffold;round adipose droplets showed intracellularly;the size of the adipocytes was not homogenous, and the density of adipocytes in transfected group was significantly higher than that in untransfected group (P = 0.007, P < 0.01). RT-PCR results showed that the expression of adipogenic gene PPARγ-2 in transfected group was much stronger than that in untransfected group. MTT test showed that there was no significant difference in optical density (A) at each time point between transfected group and nontransfected group (P = 0.056, P > 0.05). And there was also no significant difference in optical density (A) between cell group and cell-scalffold group (P = 0.066, P > 0.05). We concluded that insulin gene could obviously promote the adipogenic differentiation of hUCMSCs, and a tissue engineering adipose could be constructed by the silk fibroin scaffolds seeded with human insulin gene-modified hUCMSCs effectively in vitro.

Application of recombinant enzymes in the production of human insulin

In the present study, the cleavage activities of both recombinant and bovine enzymes （trypsin and carboxy peptidase B） were determined using proinsulin fusion protein. The proteolysis products were analyzed with HPLC. We found that recombinant enzymes had stronger activities and produced fewer by-products. In addition, recombinant enzymes were more efficient in the production of human insulin than bovine enzymes.

Secretory expression of α single-chain insulin precursor in yeast and its conversion into human insulin

A synthetic single-chain porcine insulin precursor (PIP) gene and an α-mating factor leader sequence (αMFL) gene obtained by the PCR method are inserted between the promoter and 3’-terminating sequence of the alcohol dehydrogenase gene ADH1 in plasmid pVT102-U to form plasmid pVT102-U/α MFL-PIP. The single-chain insulin precursor is expressed and secreted to the culture medium by Saccharomyces cererisiae transformed by pVT102-U/αMFL-PIP. The precursor is purified and converted into human insulin by tryptic transpeptidation. The purified human insulin is fully active and can be crystallized. The overall yield of human insulin is 25 mg per liter of culture medium.

Comparison of HbAlc in Chinese patients with type 1 or type 2 diabetes randomized to twice daily insulin lispro low mix 25 or twice daily human insulin mix 30/70

Background Glycemic control prevents onset and progression of diabetes-related long-term complications. The objective of this study was to demonstrate that twice daily insulin lispro low mix 25 is noninferior to twice daily human insulin mix 30/70 in achieving glycemic control as measured by hemoglobin Alc （HbAlc）, from baseline to endpoint, in patients with type 1 or 2 diabetes. Methods In this phase IV, crossover, open-label, multicenter study, 117 Chinese patients with diabetes were randomly assigned to one of two treatment sequence groups. One group received 12-week treatment with twice daily human insulin mix 30/70 followed by 12-week treatment with twice daily insulin lispro low mix 25, while the other group received the reverse treatment sequence. HbAlc, baseline-to-endpoint change in HbAlc, proportion of patients achieving target HbAlc ≤ 7% and 〈 6.5%, fasting blood glucose, and daily insulin doses were measured for each period. Safety and tolerability were also assessed. Results A statistically significant reduction （P≤0.0001） of HbAlc was achieved after each treatment （human insulin mix 30/70： mean HbA1c=7.91% （95% CI： 7,67%, 8.15%）; insulin lispro low mix 25： mean HbA1c=7.96% （95% CI： 7.72%, 8.20%））. The 95% Cl （-0.20, 0.10） of the difference between the two treatments satisfied the prespecified noninferiority margin of 0.3% （lower limit of 95% CI 〉 -0.3%）. No statistically significant differences between treatments were observed for any of the secondary efficacy measures. The incidence of treatment-emergent adverse events and hypoglycemia between the two treatments and treatment sequence groups was similar. Three serious adverse events were reported （human insulin mix 30/70 group： 2 patients （1.7%, hypoglycemic coma and cardiac failure）; insulin lispro low mix 25 group： 1 patient （0.9%, stroke））. All serious adverse events were resolved and no patients died during the study. Conclusion The results support noninferiority of twice daily insulin lispro low mix 25 versus twice daily human insulin mix 30/70 in HbAlc control in Chinese patients with type 1 or 2 diabetes.

CRYSTALLOGRAPHIC STUDY ON HIGHLY STABLE HUMAN INSULINS——CRYSTALLIZATION AND PRELIMINARY CRYSTALLOGRAPHIC ANALYSIS OF A21-SER MUTANT

It has long been found that insulin in acid solution is unstable. The main reason is that the A-chain C-terminal residue, asparagine, is very susceptible to acid hydrolysis, thereby a covalent-dimer formation takes place readily due to the deamidation of this residue. As a number of pharmaceutical preparations of insulin are acidic solutions, this kind of instability has brought about a serious problem on purity and storage of this preparation in

CRYSTALLOGRAPHIC STUDY ON HIGHLY STABLE HUMAN INSULINS(Ⅱ)——CRYSTALLIZATION AND PRELIMINARY CRYSTALLOGRAPHIC STUDY OF A21-GLY MUTANT

Ⅰ. INTRODUCTIONThe chemical stability of human insulin preparations is directly related to the residue of A21-Asn at C-terminal of A chain and can be distinctly increased by substituting the A21 residue in the way of protein engineering. Studying the fine three-dimensional structures

PRELIMINARY CRYSTALLOGRAPHIC STUDY ON Gly^(B30)-HUMAN INSULIN, AN ANALOGUE WITH LOW ANTIGENICITY

Ⅰ. INTRODUCTIONImmune reaction remains a challenging problem in the clinical application of various insulin preparations. It is known that about 70％ of patients will produce anti-insulin antibodies after some time even if highly pure insulin is used to treat diabetes. Therefore,it is both theoretically and practically significant to understand the molecular basis of insulin immune reaction and to find new insulin preparations with low antigenicity and full bioactivity.

STUDIES ON PRELIMINARY CRYSTALLOGRAPHY OF Arg^(B31)-HUMAN INSULIN

Ⅰ. INTRODUCTIONInsulin is a hormone protein which has been investigated in a very broad and deep scope. On the basis of the abundant knowledge on its structure-function relationship, it has been an important subject for insulin studies trying to reconstitute novel insulin derivatives with some special biological activities, such as prolonged action, higher potence and lower-antigenicity, by protein engineering so as to be advantageous to the therapeutics of diabetes.

Studies on Long-acting Insulin:Crystal Structure of Arg-B31 Human Insulin at 2.0 Resolution

The crystal structure of 2 Zn porcine insulin has been refined at 1.2 resolution. The reciprocal space refinement was restrained by the incorporation of extensive chemical observations into the least squares equations. In addition to the non-hydrogen atoms, hydrogen atoms of protein, water molecules and the bulk solvent have been determined and refined. After two cycles of anisotropic refinement of non-hydrogen atoms of insulin, the final agreement factor was 0.128 for 20,005 reflexions (F_o>1σ(F_o)) in a spacing 1.2 and the root mean squares deviation from ideal covalent bond lengths was 0.021. On the electron density maps, the appearances of weight and shape of non-hydrogen atoms were very clear and reasonable. The anisotropic appearances of sulphur atoms could be seen clearly. After anisotropic refinement, the situation fit to the electron density was improved distinctly.

Stability improvement of human collagenα1(I)chain using insulin as a fusion partner

To enhance the stability of recombinant human collagen α1(I) chains(rhCOL1 A1) in production and purification stages, a gene fragment fusing COL1 A1 and insulin protein coding domains was synthesized and inserted into the pPIC9 K expression vector. The fusion peptide-expressing Pichia pastoris strain was created by transformation.After optimization of shake flask cultures, the ultimate intracellular expression level of the insulin-collagen α1(I) chain fusion protein(INS-COL1 A1) reached about 300 mg·L^(-1), and no obvious protein degradation was found in the fermentation and purification processes. The His-tagged recombinant fusion protein was detected by western blotting and was effectively purified using Ni^(2+)-chelating chromatography. A prominent improvement in the stability of INS-COL1 A1 was observed compared to rhCOL1 A1 in vitro, and the rhCOL1 A1 released from the fusion protein was studied by LC–MS/MS and in bioassays. The results showed that the purified rhCOL1 A1 was consistent with the native protein in amino acid composition and had a similar biological compatibility. To our knowledge, this is the first study to demonstrate the use of insulin as a fusion protein to improve the stability of easily degradable proteins.

Effects of Exogenous Growth Hormone on Growth Hormone-Insulin-Like Growth Factor Axis of Human Gastric Cancer Cell

Aim: To study effects of recombinant human growth hormone (rhGH) on growth hormone-insulin-like growth factor axis (GH-IGFs) of human gastric cancer cell in vivo in order to reveal part mechanism of growth effects of rhGH on gastric cancer. Methods: Nude mice were randomly divided into control group, cisplatin (DDP) group, rhGH group and DDP + rhGH group after human gastric cancer xenograft model of node mice was successfully founded and drugs were used for 6 days. We investigated volume of tumor, inhibitory rate of tumor and cell cycle by slide gauge and flow cytometry. In addition, We also respectively investigated insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) of blood serum of nude mice, IGF-ImRNA, insulin-like growth factor-I receptor (IGF-IR) mRNA and IGFBP-3 mRNA of xenograft of nude mice by enzyme linked immunosorbent assay (ELISA) and semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) on the first day of completing use of drugs later. Results: Tumor grew obviously slowly and tumor inhibitory rate obviously rose in DDP group and DDP + rhGH group compared with control group and rhGH group (p p p < 0.05). Expressions of IGF-I mRNA and IGF-IR mRNA were not obviously different in all groups. But expression of IGFBP-3 mRNA obviously increased in rhGH group, DDP group and DDP + rhGH group compared with control group;meanwhile, expression of IGFBP-3 mRNA also obviously increased in DDP + rhGH group compared with control group, DDP group and rhGH group. Conclusion: Our results indicated rhGH in short-time use did not improve proliferation of human gastric cancer cells and its mechanism was possible that rhGH in short-time use raised simultaneously IGF-I and IGFBP-3 of blood serum and increased IGFBP-3 mRNA, but degraded ratio of IGF-I and IGFBP-3 of blood serum in human gastric cancer cells.

scAAV9-IGF-1对SOD1-G93A小鼠抗凋亡通路的作用

目的 探索以自我互补双链腺相关病毒9为载体介导的人胰岛素样生长因子-1 (scAAV9-IGF-1)对SOD1-G93A转基因小鼠抗凋亡通路的作用。方法 采用肌萎缩侧索硬化(ALS)的动物模型即转基因SOD1-G93A突变型及野生型(wild type-SOD1,WT-SOD1)小鼠,在其出生后60 d龄时,雌性同窝阳性SOD1-G93A转基因小鼠采用随机的方法分配到治疗组及溶剂对照组,治疗组全身多点肌肉注射scAAV9-IGF-1,溶剂对照组多点肌肉注射AAV9-GFP,同年龄WT-SOD1作为阴性对照组。在肌肉注射40~50 d后,利用PCR技术检测腰髓中IGF-1含量的变化,同时检测抗凋亡通路因子Bcl-xl、Bcl-2的mRNA含量变化,通过免疫组化染色观察抗凋亡通路因子Bcl-xl、Bcl-2在小鼠腰髓前角神经元中的表达。结果 PCR技术检测显示scAAV9-IGF-1处理后,腰髓中IGF-1的mRNA含量显著高于GFP对照组,抗凋亡通路因子Bclxl、Bcl-2的mRNA含量均高于溶剂对照组(均P<0.05),而与WT组差异无统计学意义。免疫组化染色结果显示,治疗组中抗凋亡通路蛋白Bcl-xl,Bcl-2在小鼠腰髓前角神经元中的表达多于溶剂对照组,并且与WT阴性对照组相当。结论 scAAV9-IGF-1可以激活SOD1-G93A转基因小鼠模型中的抗凋亡通路,其通过上调Bcl-xl,Bcl-2的mRNA水平,进而增加Bcl-xl、Bcl-2的蛋白表达,从而产生抗凋亡的作用。

重组人生长激素治疗对身材矮小症患儿血清IGF-1、Ghrelin及LP水平的影响

目的探讨重组人生长激素(rhGH)治疗对身材矮小症患儿的疗效及其对血清胰岛素样生长因子-1(IGF-1)、饥饿激素(Ghrelin)及瘦素(LP)水平的影响。方法选择该院2021年1—12月收治的身材矮小症患儿79例为研究对象,按照随机数字表法将其分为对照组39例和观察组40例。对照组采用加强营养,并补充钙质、微量元素和各种维生素等常规治疗,观察组在常规治疗的基础上给予rhGH治疗,两组治疗时间均为12个月。比较两组患儿治疗前和治疗12个月后身高、生长速度、身高标准差积分(HtSDS)及血清IGF-1、Ghrelin、LP水平变化,比较两组不良反应发生情况。结果治疗前,两组患儿身高、生长速度、HtSDS及血清IGF-1、Ghrelin、LP水平比较,差异均无统计学意义(P>0.05);治疗12个月后,两组患儿身高、HtSDS及血清IGF-1、LP水平均高于治疗前,生长速度均快于治疗前,血清Ghrelin水平均低于治疗前,差异均有统计学意义(P<0.05);观察组患儿治疗12个月后身高、HtSDS及血清IGF-1、LP水平均高于对照组,生长速度快于对照组,血清Ghrelin水平低于对照组,差异均有统计学意义(P<0.05);对照组患儿治疗期间未出现任何不良反应,观察组治疗期间出现甲状腺功能减退1例,膝部疼痛2例,但两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论rhGH可有效改善身材矮小症患儿血清IGF-1、Ghrelin及LP水平,促进患儿生长,临床疗效满意,安全性高,值得临床应用。

精蛋白人胰岛素注射液对GDM患者血糖及妊娠结局的影响

目的:探究门冬胰岛素联合精蛋白人胰岛素注射液治疗妊娠期糖尿病(GDM)对患者血红蛋白(HGB)、C反应蛋白(CRP)、C肽(CP)及血糖和安全性影响。方法:选取2020年12月-2023年12月本院治疗的GDM患者106例,双色球分组法分为常规组和观察组各53例。两组均给予门冬胰岛素降糖治疗,观察组给予精蛋白合成人胰岛素注射治疗,两组均治疗2个月。治疗前后分别检测空腹血糖(FBG)、糖化血红蛋白(HbA1c)和餐后2 h血糖(2hPG)水平,空腹胰岛素(FINS)水平并计算胰岛素抵抗指数(HOMA-IR),HGB、CP、CRP和白介素-6(IL-6)水平;收集两组不良妊娠结局。结果:治疗2个月后两组FBG、HbAlc、2hPG、HOMA-IR、HGB、CRP和IL-6均降低,且观察组(4.06±0.28 mmol/L、4.15%±0.26%、5.05±0.36 mmol/L、2.29±0.47、134.79±5.32 g/L、5.01±0.12 mg/L、6.33±0.70 ng/ml)均低于常规组(5.11±0.48 mmol/L、5.31%±0.56%、6.46±0.38mmol/L、2.52±0.56、138.12±9.95g/L、6.96±0.34mg/L、7.59±0.82ng/ml),两组FINS、CP均升高,且观察组(8.61±0.38 mU/L、1.90±0.26mg/L)高于常规组(7.89±0.31mU/L、1.67±0.22 mg/L),不良妊娠结局发生率观察组(11.3%)低于常规组(32.1%)(均P<0.05)。结论:门冬胰岛素联合应用精蛋白人胰岛注射液治疗GDM,可有效改善患者血糖水平,升高HGB和CP水平,降低炎症因子水平和不良妊娠结局,临床应用效果和安全性均较好。

精蛋白生物合成人胰岛素、地特胰岛素分别联合门冬胰岛素治疗GDM的效果观察

目的探讨精蛋白生物合成人胰岛素、地特胰岛素分别联合门冬胰岛素对妊娠期糖尿病(GDM)孕妇糖脂代谢及母婴结局的影响,以期为临床治疗提供参考。方法本研究选取2021年1月—2023年12月遂宁市中医院收治的120例GDM孕妇为研究对象。采用随机数字表法将孕妇分为观察组与对照组,每组60例。2组孕妇均给予门冬胰岛素治疗。对照组孕妇在门冬胰岛素应用基础上给予精蛋白生物合成人胰岛素治疗;观察组孕妇在门冬胰岛素应用基础上联合地特胰岛素治疗。2组孕妇均以治疗2周为1个疗程,比较治疗前、治疗4个疗程时的血糖控制情况[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2h血糖(2hFPG)]、血脂水平[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]及胰岛素相关指标[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、空腹胰岛素水平(FINs)]水平变化。比较2组孕妇低血糖事件发生情况及母婴结局。结果治疗前,2组孕妇FPG、2h-PBG、HbAlc水平比较,差异无统计学意义(P>0.05)。治疗4个疗程时,2组孕妇FPG、2h-PBG、HbAlc水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组孕妇TC、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05)。治疗4个疗程时,2组孕妇TC、LDL-C水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗4个疗程时,2组孕妇HDL-C水平均高于治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组孕妇HOMA-IR、HOMA-β、FINs水平比较,差异无统计学意义(P>0.05)。治疗4个疗程时,2组孕妇HOMA-IR及FINs水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗4个疗程时,2组孕妇HOMA-β水平均高于治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组孕妇低血糖事件发生率比较,差异无统计学意义(P>0.05)。2组孕妇剖宫产、胎膜早破发生率及总发生率比较,差异均无统计学意义(P>0.05)。2组新生儿早产、高胆红素血症、巨大儿发生率及总发生率比较,差异均无统计学意义(P>0.05)。结论地特胰岛素联合门冬胰岛素可有效改善GDM孕妇血糖、血脂水平,恢复胰岛β细胞功能,提高临床疗效,且不增加低血糖及不良妊娠结局风险,值得推广。