Fan Xiaojun, Wang Chuan, Chen Li, Zhao Xuehui, Wu Yongkun, Zeng Guangxia
Department of Obstetrics, Baoji Maternal and Child Health Hospital No. 2 East Section of Xinjian Road, Weibin District, Baoji 721000, Shaanxi, China.
Department of Obstetrics, Ankang Central Hospital No. 85 Jinzhou South Road, Hanbin District, Ankang 725000, Shaanxi, China.
Am J Transl Res. 2024 Apr 15;16(4):1177-1187. doi: 10.62347/NIGM4906. eCollection 2024.
To investigate the impact of combining metformin with insulin aspart on blood glucose control, renal injury, and pregnancy outcome in gestational diabetes mellitus (GDM) patients.
In this retrospective analysis, the clinical data of 140 GDM patients treated at Baoji Maternal and Child Health Hospital between March 2020 and March 2022 were studied. The patients were divided into a control group (insulin aspart alone, n=64) and an observation group (combination of insulin aspart and metformin, n=76) according to their treatment regimen. The blood glucose metabolism, renal injury markers, and pregnancy outcomes between the two groups were assessed and compared.
The observation group demonstrated significantly lower levels of blood glucose metabolism markers (fasting plasma glucose [FPG], fasting insulin [FINS], mean amplitude of glycemic excursions [MAGE], and mean of daily differences [MODD]), renal injury indicators (microalbuminuria [mAlb], serum cystatin C [CysC], free fatty acids [FFA], and neutrophil gelatinase-associated lipocalin [NGAL]), and inflammatory markers (interleukin-6 [IL-6], transforming growth factor-β1 [TGF-β1], and lipoprotein-associated phospholipase A2 [Lp-PLA2]) compared to the control group (all P<0.05). Additionally, the incidence of adverse pregnancy outcomes in both newborns and mothers was lower in the observation group (P<0.05). Logistic regression analysis identified the treatment regimen, patient age, and pre-pregnancy BMI as independent risk factors for adverse pregnancy outcome.
The combination of metformin and insulin aspart in treating GDM can effectively reduce blood glucose levels, mitigate renal injury, and improve pregnancy outcome. This treatment approach presents a viable option for optimizing maternal and fetal health in GDM cases.
探讨二甲双胍与门冬胰岛素联合应用对妊娠期糖尿病（GDM）患者血糖控制、肾损伤及妊娠结局的影响。
本回顾性分析研究了2020年3月至2022年3月在宝鸡市妇幼保健院接受治疗的140例GDM患者的临床资料。根据治疗方案将患者分为对照组（单纯门冬胰岛素治疗，n = 64）和观察组（门冬胰岛素与二甲双胍联合治疗，n = 76）。评估并比较两组患者的血糖代谢、肾损伤标志物及妊娠结局。
与对照组相比，观察组的血糖代谢指标（空腹血糖[FPG]、空腹胰岛素[FINS]、血糖波动幅度均值[MAGE]和每日差异均值[MODD]）、肾损伤指标（微量白蛋白尿[mAlb]、血清胱抑素C[CysC]、游离脂肪酸[FFA]和中性粒细胞明胶酶相关脂质运载蛋白[NGAL]）以及炎症标志物（白细胞介素-6[IL-6]、转化生长因子-β1[TGF-β1]和脂蛋白相关磷脂酶A2[Lp-PLA2]）水平均显著降低（均P<0.05）。此外，观察组新生儿和母亲的不良妊娠结局发生率较低（P<0.05）。Logistic回归分析确定治疗方案、患者年龄和孕前BMI为不良妊娠结局的独立危险因素。
二甲双胍与门冬胰岛素联合治疗GDM可有效降低血糖水平，减轻肾损伤，并改善妊娠结局。这种治疗方法为优化GDM患者的母婴健康提供了一种可行的选择。
