胰岛素对不同孕周妊娠期糖尿病患者血糖水平及妊娠结局的影响

目的探讨胰岛素对不同孕周妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖水平及妊娠结局的影响。方法选取2013年2月至2016年5月在海南现代妇婴医院产检及生产的GDM患者共117例,根据胰岛素首次治疗孕周分为研究组59例(≤32孕周)和对照组58例(32孕周)。两组患者均在坚持合理运动、饮食基础上行胰岛素治疗,比较两组血糖水平变化、妊娠结局以及新生儿并发症情况。结果两组分娩前血糖水平(空腹和餐后2 h)均低于入院时(P0.05),且研究组血糖水平比对照组降低更明显,差异有统计学意义(P0.05);两组剖宫产发生率比较差异无统计学意义(P0.05),研究组妊娠期高血压疾病、羊水过多、产后出血感染发生率均低于对照组(P0.05),早产发生率高于对照组(P0.05);两组巨大儿发生率比较差异无统计学意义(P0.05),研究组新生儿窒息、新生儿低血糖、高胆红素血症、低体重儿发生率均低于对照组(P0.05)。结论 GDM患者在32孕周前采取胰岛素治疗,可有效控制血糖水平,改善妊娠结局,取得满意的临床效果。

Effects of insulin on blood glucose level and pregnancy outcomes in different gestational diabetes mellitus patients

Objective To investigate the effects of insulin on blood glucose level and pregnancy outcomes in different gestational diabetes mellitus(GDM) patients.Methods 117 cases of GDM patients inspected and deliveried in Hainan Modern Maternal and Child Hospital from February 2013 to May 2016 were selected.According to the first treatment of insulin, they were divided into study group of 59 cases (≤32 weeks of gestation) and control group of 58 cases (>32 weeks of gestation).Two groups of patients were adhere to reasonable exercise and diet based on insulin treatment.Compared the two groups of blood glucose levels, pregnancy outcomes and neonatal complications.Results Blood glucose levels (fasting and postprandial 2 h) were lower in both groups(P<0.05), and blood glucose level of the study group was lower than that of the control group, the difference was statistically significant(P<0.05);There was no significant difference in the incidence of cesarean section between the two groups(P>0.05), The incidence of hypertension, hyperactivity and postpartum hemorrhage in the study group were lower than that in the control group(P<0.05), The incidence of preterm birth was higher than that of the control group(P<0.05);There was no statistically significant difference between the two groups in the incidence of macrosomia(P>0.05);The incidence of neonatal asphyxia, neonatal hypoglycemia, hyperbilirubinemia and low birth weight were lower in the study group than in the control group(P<0.05).Conclusion Treating GDM patients with insulin before 32 weeks of gestation can effectively control blood glucose levels, improve pregnancy outcomes and to achieve satisfactory clinical results.