Grandis A S, Morris M A, Litton J C
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710.
Am J Obstet Gynecol. 1987 Nov;157(5):1118-21. doi: 10.1016/s0002-9378(87)80273-9.
To assess the effects of diet and insulin therapy on pregnancy complicated by gestational diabetes, glycosylated hemoglobin concentration was determined longitudinally in 32 women. Diet was instituted when a diagnosis of gestational diabetes was made and was supplemented with insulin for fasting hyperglycemia. At initial presentation, glycosylated hemoglobin concentration was increased in the 18 women who required insulin compared with the 14 women managed by diet alone (7.1% +/- 0.2% versus 6.2% +/- 0.2%, mean +/- SEM, p less than 0.01). Diet had no effect on glycosylated hemoglobin concentration that remained elevated to 6.1% +/- 0.3% compared with the glycosylated hemoglobin concentration of 5.6% +/- 0.2% for pregnant nondiabetic women (p less than 0.01). Insulin resulted in a decrease in glycosylated hemoglobin concentration within 3 to 5 weeks (p less than 0.05). After 7 to 9 weeks of insulin and diet, the glycosylated hemoglobin concentration in women with fasting hyperglycemia was the same as the glycosylated hemoglobin concentration in women who were managed by diet alone.
为评估饮食和胰岛素治疗对妊娠合并妊娠期糖尿病的影响，对32名女性进行了糖化血红蛋白浓度的纵向测定。确诊妊娠期糖尿病后即开始饮食治疗，空腹血糖过高时加用胰岛素。初次就诊时，18名需要胰岛素治疗的女性糖化血红蛋白浓度高于仅采用饮食治疗的14名女性（分别为7.1%±0.2%和6.2%±0.2%，均值±标准误，p<0.01）。饮食对糖化血红蛋白浓度无影响，与非糖尿病孕妇糖化血红蛋白浓度5.6%±0.2%相比，仍升高至6.1%±0.3%（p<0.01）。胰岛素治疗3至5周内糖化血红蛋白浓度下降（p<0.05）。胰岛素和饮食治疗7至9周后，空腹血糖过高女性的糖化血红蛋白浓度与仅采用饮食治疗女性的糖化血红蛋白浓度相同。
