胰岛素不同给药方式与二甲双胍联合对妊娠期糖尿病血糖改善的积极意义  

Positive Significance of Different Insulin Administration Modes Combined with Metformin in Improving Blood Glucose in Gestational Diabetes Melli⁃tus

作　　者：鲍彩霞 饶永红[2] BAO Caixia;RAO Yonghong(Department of Obstetrics and Gynecology,the Sixth People's Hospital of Macheng City,Macheng 438300,Hubei,China;Department of Obstetrics and Gynecology,Huanggang Maternal and Child Health Hospital,Huanggang 438000,Hubei,China)

机构地区：[1]麻城市第六人民医院妇产科,湖北麻城438300 [2]黄冈市妇幼保健院妇产科,湖北黄冈438000

出　　处：《糖尿病新世界》2024年第10期58-61,共4页Diabetes New World

摘　　要：目的分析二甲双胍联合胰岛素泵注射对妊娠期糖尿病的控糖效果。方法回顾性选取2021年5月—2023年12月麻城市第六人民医院收治的65例妊娠糖尿病患者的临床资料,根据不同治疗方法将患者分为两组,所有患者均给予二甲双胍的基础上,观察组(33例)给予胰岛素泵注射,对照组(32例)给予胰岛素常规注射,比较两组患者的血糖指标(空腹血糖、餐后2 h血糖以及糖化血红蛋白)、胰岛素抵抗指标(空腹胰岛素和胰岛素抵抗指数)、不良妊娠结局(早产、产后出血、流产)和不良新生儿结局(新生儿窒息、低血糖、巨大儿、呼吸窘迫)。结果治疗后,观察组的血糖指标均低于对照组,差异有统计学意义(P均<0.05)。观察组的胰岛素抵抗指标均低于对照组,差异有统计学意义(P均<0.05)。观察组不良妊娠结局总发生率和新生儿不良结局总发生率均低于对照组,差异有统计学意义(P均<0.05)。结论妊娠期糖尿病患者在给予二甲双胍的基础上,搭配胰岛素泵实施皮下注射,可使血糖水平降低,胰岛素抵抗得到合理控制,改善母婴结局,安全有效。Objective To analyze the glucose-controlling effect of metformin combined with insulin pump injection on gestational diabetes mellitus.Methods Clinical data of 65 patients with gestational diabetes mellitus admitted to the Sixth People's Hospital of Macheng City from May 2021 to December 2023 were retrospectively selected.According to the dif-ferent treatment methods,the patients were divided into two control groups.On the basis of metformin given to all patients,the observation group(33 cases)was given insulin pump injection,and the control group(32 cases)was given routine insu-lin injection.Blood glucose indicators(fasting blood glucose,2-hour postprandial blood glucose,and glycated hemoglobin A1c),insulin resistance indicators(fasting insulin and homeostasis model assessment insulin resistance),adverse preg-nancy outcomes(preterm birth,postpartum hemorrhage,miscarriage),and adverse neonatal outcomes(neonatal asphyxia,hypoglycemia,macronesia,respiratory distress)were compared between the two groups.Results After treatment,the blood glucose indexes in the observation group were lower than those in the control group,and the differences were statisti-cally significant(all P<0.05).The insulin resistance indexes of observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).The total incidences of adverse pregnancy outcomes and adverse neonatal outcomes in the observation group were lower than that in the control group,and the differences were statistically significant(both P<0.05).Conclusion In patients with gestational diabetes mellitus,subcutaneous injection combined with insulin pump on the basis of metformin can reduce the level of blood glucose stably,reasonably control in-sulin resistance,improve maternal and infant outcomes,safe and effective.

关 键 词：胰岛素 不同给药方式 二甲双胍 妊娠期糖尿病 血糖改善 

分 类 号：R587.1[医药卫生—内分泌]