妊娠糖尿病胰岛素治疗与围生儿预后

目的 探讨在妊娠糖尿病（GDM）治疗中胰岛素、饮食以及开始治疗时间早晚对围生儿预后的影响。方法 选择诊断为妊娠糖尿病者109例，其中采用饮食加胰岛素治疗22例，单纯饮食控制组低于应用胰岛素组，差异显著（P＜0.05）。围生儿结局显示：巨大儿发生率、红细胞增多症发生率三组为34周后饮食控制组＞34周前饮食控制组＞胰岛素治疗组。结论 GDM要早诊断、早治疗，尤其是应用胰岛素正规治疗对降低围生儿病率、巨大发生率以及控制孕妇血糖水平有重要意义。

Neonatal outcome and insulin therapy in gestational diabetes mellitus

objective To investigate the effects of the methods of therapy on gestational diabetes mellitus (GDM);the effects of using insulin,diet controlling and the time of beginning systematical therapy on the neonatal outcome.Methods Among the 109 gestational diabetes mellitus women who were diagnosed from August 1997 to October 1999,22 cases were performed insulin therapy with diet controlling,87 cases diet controlling,among which 60 cases began to control their diet before 34 gestational weeks and 27 cases began after 34 weeks.Results In diet controlling group the extent of the decline of glucose level was significantly lower than that in insulin therapy group (P<0.05).The neonatal outcome:the rates of macrosomia,erythrocytosis were the highest in diet controlling group which began after 34 gestational weeks,the second higher was in the group which began diet controlling before 34 weeks,the insulin group was the lowest.Conclusion Diagnosing and begining therapy as soon as possible and using insulin are important to GDM,especially to reduce the rate of macrosomia and control mother's glucose.