Wang Yan, Song Min, Qi Bang-Ruo
Department of Obstetrics and Gynecology, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572099, Hainan Province, China.
Department of Obstetrics and Gynecology, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572099, Hainan Province, Chinam.
World J Diabetes. 2023 Oct 15;14(10):1532-1540. doi: 10.4239/wjd.v14.i10.1532.
Gestational diabetes mellitus (GDM) refers to hyperglycemia caused by insulin resistance or insufficient insulin secretion during pregnancy. Patients with GDM have a high risk of pregnancy complications, which can adversely affect both maternal and fetal health. Therefore, early diagnosis, treatment and monitoring of GDM are essential. In recent years, a new treatment scheme represented by insulin aspart combined with metformin has received increasing attention.
To explore the effects of insulin aspart combined with metformin on patients with GDM and inflammatory markers.
From April 2020 to September 2022, 124 patients with GDM in Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center were collected and analyzed retrospectively. The control group (CG) comprised 62 patients treated with insulin aspart alone, and 62 patients treated with insulin aspart and metformin formed the observation group (OG). Before and after treatment, improvement of blood-glucose-related indexes [fasting blood glucose (FBG), 2-h postprandial glucose (2h PG) and hemoglobin A1c (HbA1c)], serum related factor [serum homocysteine (Hcy)], serum inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-6 and C-reactive protein (CRP)] were compared between the two groups. The clinical efficacy, adverse pregnancy outcomes and incidence of pregnancy complications were compared between the two groups.
After treatment, the levels of FBG, 2h PG, HbA1c, Hcy, TNF-α, IL-6 and CRP in both groups were significantly decreased ( < 0.05), and the levels of FBG, 2h PG, HbA1c, Hcy, TNF-α, IL-6 and CRP in the OG were lower than in the CG ( < 0.05). The total clinical effectiveness in the OG was higher than that in the CG ( < 0.05). The total incidence of adverse pregnancy outcomes and complications in the OG was significantly lower than in the CG ( < 0.05).
Insulin aspart combined with metformin are effective for treatment of GDM, which can reduce blood-glucose-related indexes, Hcy and serum inflammatory cytokines, and risk of adverse pregnancy outcomes and complications.
妊娠期糖尿病（GDM）是指妊娠期间因胰岛素抵抗或胰岛素分泌不足引起的高血糖。GDM患者发生妊娠并发症的风险较高，会对母婴健康产生不利影响。因此，GDM的早期诊断、治疗和监测至关重要。近年来，以门冬胰岛素联合二甲双胍为代表的新治疗方案受到越来越多的关注。
探讨门冬胰岛素联合二甲双胍对GDM患者及炎症标志物的影响。
回顾性收集并分析2020年4月至2022年9月在上海儿童医学中心管理的三亚妇女儿童医院的124例GDM患者。对照组（CG）包括62例仅接受门冬胰岛素治疗的患者，62例接受门冬胰岛素和二甲双胍治疗的患者构成观察组（OG）。比较两组治疗前后血糖相关指标[空腹血糖（FBG）、餐后2小时血糖（2h PG）和糖化血红蛋白（HbA1c）]、血清相关因子[血清同型半胱氨酸（Hcy）]、血清炎症细胞因子[肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6和C反应蛋白（CRP）]的改善情况。比较两组的临床疗效、不良妊娠结局及妊娠并发症发生率。
治疗后，两组的FBG、2h PG、HbA1c、Hcy、TNF-α、IL-6和CRP水平均显著降低（P<0.05），且OG组的FBG、2h PG、HbA1c、Hcy、TNF-α、IL-6和CRP水平低于CG组（P<0.05）。OG组的总临床有效率高于CG组（P<0.05）。OG组不良妊娠结局和并发症的总发生率显著低于CG组（P<0.05）。
门冬胰岛素联合二甲双胍治疗GDM有效，可降低血糖相关指标、Hcy及血清炎症细胞因子水平，以及不良妊娠结局和并发症的风险。
