Qiu Huiying, Li Jinfen, Chen Caiyan, Xiao Feng
Department of Paediatrics, Zhongshan Hospital Xiamen University Xiamen 361004, Fujian, China.
Department of Paediatrics, The Fourth Affiliated Hospital of Soochow University Suzhou 215000, Jiangsu, China.
Am J Transl Res. 2024 Aug 15;16(8):4200-4207. doi: 10.62347/PKAY4284. eCollection 2024.
Gestational diabetes mellitus (GDM) presents not only immediate challenges affecting maternal and infant health but also long-term consequences. Effective prevention and treatment of GDM are crucial for minimizing the short- and long-term health impacts.
This retrospective study evaluated the effects of insulin aspart injection plus high-dose vitamin D (HD-VD) supplementation on treatment outcomes and maternal - infant outcomes in patients with GDM.
A total of 129 GDM patients admitted to the Zhongshan Hospital Xiamen University from December 2021 to December 2023 were included in this study. According to the intervention regimen, the patients were divided into two groups: a control group of 59 patients receiving insulin aspart injection plus low-dose vitamin D (LD-VD) supplementation and a research group of 70 cases receiving insulin aspart injection plus HD-VD supplementation. The curative effect, blood glucose metabolism (fasting blood glucose [FPG], 2-hour postprandial blood glucose [2hPG], and glycosylated hemoglobin [HbA1c]), homocysteine (HCY), and cystatin C (Cys C), maternal and infant outcomes (maternal outcomes: hypoglycemia, cesarean section, polyhydramnios, and premature rupture of membranes; neonatal outcomes: stillbirth, macrosomia, neonatal respiratory distress syndrome, and Apgar score) were recorded and compared between the two groups. Risk factors affecting maternal and infant outcomes were analyzed.
The research group demonstrated a higher overall effective rate in compared to the control group (P<0.05). Post-treatment measurements of FPG, 2hPG, HbA1c, HCY, and Cys C in the research group were statistically lower than the pre-treatment levels and those in the control group (all P<0.05). Additionally, the research group showed better maternal and neonatal outcomes, with fewer adverse pregnancy-related conditions and better neonatal health indicators, including higher Apgar scores (P<0.05). Besides, insulin aspart injection plus high-dose vitamin D was a protective factor for maternal and infant outcomes (P<0.05).
Insulin aspart injection plus HD-VD supplementation markedly enhances treatment efficacy and improves maternal and infant outcomes in GDM.
妊娠期糖尿病（GDM）不仅带来影响母婴健康的直接挑战，还会产生长期后果。有效预防和治疗GDM对于将短期和长期健康影响降至最低至关重要。
本回顾性研究评估了门冬胰岛素注射联合高剂量维生素D（HD - VD）补充对GDM患者治疗结局和母婴结局的影响。
本研究纳入了2021年12月至2023年12月在厦门大学附属中山医院收治的129例GDM患者。根据干预方案，将患者分为两组：对照组59例，接受门冬胰岛素注射联合低剂量维生素D（LD - VD）补充；研究组70例，接受门冬胰岛素注射联合HD - VD补充。记录并比较两组的治疗效果、血糖代谢指标（空腹血糖[FPG]、餐后2小时血糖[2hPG]和糖化血红蛋白[HbA1c]）、同型半胱氨酸（HCY）和胱抑素C（Cys C）、母婴结局（母亲结局：低血糖、剖宫产、羊水过多和胎膜早破；新生儿结局：死产、巨大儿、新生儿呼吸窘迫综合征和阿氏评分）。分析影响母婴结局的危险因素。
研究组的总有效率高于对照组（P<0.05）。研究组治疗后FPG、2hPG、HbA1c、HCY和Cys C的测量值在统计学上低于治疗前水平及对照组（均P<0.05）。此外，研究组的母婴结局更好，不良妊娠相关情况更少，新生儿健康指标更佳，包括更高的阿氏评分（P<0.05）。此外，门冬胰岛素注射联合高剂量维生素D是母婴结局的保护因素（P<0.05）。
门冬胰岛素注射联合HD - VD补充显著提高了GDM的治疗效果并改善了母婴结局。
