摘要
目的:探讨门冬胰岛素联合不同剂量维生素D治疗妊娠期糖尿病(GDM)对患者糖脂代谢、胰岛素抵抗及分娩结局的影响。方法:本院2018年1月—2022年1月收治的93例GDM患者按照随机数字表法分为低剂量组46例和高剂量组47例,分别给予门冬胰岛素联合低剂量维生素D(10U/次)或(30U/次)治疗1个月。观察两组治疗后糖脂代谢指标及胰岛素抵抗变化,随访两组分娩结局。结果:治疗后与低剂量组比较,高剂量组空腹血糖(5.29±0.76 mmol/L)、餐后2 h血糖(6.64±0.82 mmol/L)、糖化血红蛋白(5.11±0.34)%水平更低,空腹胰岛素(11.89±1.04 mU/L)、胰岛素抵抗指数(3.24±0.41)水平更低,β细胞功能指数(0.98±0.13 mmol/L)水平更高,总胆固醇(3.21±0.75 mmol/L)、甘油三酯(3.03±0.86 mmol/L)、低密度脂蛋白(3.12±0.76)更低,剖宫产(17.0%)、早产(23.4%)、胎膜早破(12.8%)、巨大儿(8.5%)发生率更低(均P<0.05)。结论:门冬胰岛素联合高剂量维生素D更利于GDM患者改善血糖、血脂水平,减轻胰岛素抵抗,降低母婴并发症。
Objective:To explore the effects of insulin aspart combined with different doses of vitamin D for treating pregnant women with gestational diabetes mellitus(GDM)on their glucolipid metabolism,insulin resistance,and delivery outcomes.Methods:93pregnant women with GDM who had been treated in the hospital were divided into group A(46women treated with low-dose of vitamin D 10U/time for 1month)and group B(47women treated with highdose of vitamin D 30U/time)according to the random number table method from January 2018to January 2022.The changes of glycemic and lipid metabolism indexes and insulin resistance of the women in the two groups after treatment were observed.The delivery outcomes of the women in the two groups were followed up.Results:After treatment,the levels of fasting blood glucose(5.29±0.76mmol/L),the 2hpost-meal blood glucose(6.64±0.82mmol/L),and the HBA1c(5.11±0.34%)of the women in group B were significantly lower than those of the women in group A.After treatment,the levels of fasting insulin(11.89±1.04mU/L)and insulin resistance index(3.24±0.41)of the women in group B were significantly lower than those of the women in group A.After treatment,theβ?cell function index(0.98±0.13mmol/L)of the women in group B was significantly higher than that of the women in group A.The levels of total cholesterol(3.21±0.75mmol/L),triglyceride(3.03±0.86mmol/L),and low-density lipoprotein(3.12±0.76),and the incidences of cesarean section(17.0%),premature delivery(23.4%),premature rupture of membranes(12.8%),and macrosomia(8.5%)of the women in group B were significantly lower than those of the women in group A(all P<0.05).Conclusion:Insulin aspart combined with high-dose vitamin D is more conducive to the improvements of blood glucose and blood lipids of the patients with GDM,and which can reduce the insulin resistance of the women,and has lower the maternal-infant complications rate.
作者
葛慧慧
方朝晖
付金强
GE Huihui;FANG Zhaohui;FU Jinqiang(Guoyang Branch of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Bozhou,Anhui Province,233600;The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei,Anhui Province)
出处
《中国计划生育学杂志》
2023年第7期1542-1545,1550,共5页
Chinese Journal of Family Planning
关键词
妊娠期糖尿病
门冬胰岛素
不同剂量维生素D
胰岛素抵抗
血糖
血脂
分娩结局
Gestational diabetes mellitus
Insulin aspart
Different dosage of vitamin D
Insulin resistance
Blood glucose
Blood lipid
Delivery outcome
