摘要
Abstract
Objective To explore the clinical curative effect of metformin combined with insulin aspart in pregnant women with type A2 gestational diabetes mellitus(GDM).Methods According to different medication methods,pregnant women with type A2 GDM were divided into control group[subcutaneous injection of insulin aspart(0.5-1.0 U·kg-2·d-1)immediately before three meals a day]and treatment group(oral 0.25 g metformin with meals on basis of control group).All pregnant women were treated till delivery.The clinical curative effect,fasting plasma glucose(FPG),fasting insulin(FINS),2 h postprandial blood glucose(2 h PBG),homeostasis model assessment-β(HOMA-β),homeostatic model assessment of insulin resistance(HOMA-IR)and insulin dosage after 2 weeks of treatment,safety evaluation and pregnancy outcomes were compared between the two groups.Results There were 31 cases in treatment group and 37 cases in control group.The difference in total response rate between control group and treatment group was statistically significant[64.52％(20 cases/31 cases)vs 86.49％(32 cases/37 cases),P＜0.05].After treatment,FPG levels in treatment group and control group were(5.04±0.86)and(4.16±0.90)mmol·L-1,2 h PBG levels were(7.51±1.12)and(5.76±0.93)mmol·L-1,FINS levels were(12.97±1.03)and(17.34±1.79)mU·L-1,HOMA-β levels were 393.04±56.93 and 225.19±35.47,HOMA-IR levels were 2.40±0.17 and 3.87±0.28,insulin dosages were(33.71±4.62)and(26.95±3.47)U·kg-1·d-1,the differences were statistically significant(all P＜0.05).The differences in incidence of cesarean section and macrosomia between treatment group and control group were statistically significant(48.39％,2.70％vs 51.61％,19.35％,P＜0.05),but the difference in incidence of adverse reactions was not statistically significant(18.92％vs 9.68％,P＞0.05).Conclusion Metformin combined with insulin aspart before three meals can effectively improve glucose control effect,lower blood glucose level,reduce insulin dosage and improve pregnancy outcomes in pregnant women with type A2 GDM.关键词
二甲双胍/门冬胰岛素/妊娠糖尿病/空腹血糖/妊娠结局Key words
metformin/insulin aspart/gestational diabetes mellitus/fasting blood glucose/pregnancy outcome分类
医药卫生
