胰岛素持续皮下输注治疗妊娠糖尿病疗效及安全性的临床观察

目的：比较胰岛素持续皮下输注（CSII）与胰岛素多次皮下注射（MSII）方案治疗妊娠糖尿病（GDM）的疗效及安全性。方法：GDM 患者64例随机分为 CSII 组32例和 MSII 组32例，治疗2个月。比较治疗前后 FPG、2hPG、HbA1C、24h 血糖波动情况及低血糖事件发生情况。结果：（1）治疗后，两组 FPG 和 HbA1C 均较治疗前降低，但两组比较差异无统计学意义；（2）CSII 组24h 内平均血糖波动幅度（MAGE）、全天血糖值标准差（sDBG）、日间血糖平均绝对差（MODD）均低于 MSII 组，[MAGE：（1.9±0.5）VS（2.2±0.4）mmol/L；SDBG：（2.1±0.3）VS（2.4±0.4）mmol/L；MODD：（3.3±1.4）VS（4.1±1.5）mmol/L，P<0.05]；（3）CSII 组低血糖发生率低 MSII 组，但两组均无严重低血糖事件。结论：CSII 治疗血糖波动较大的妊娠糖尿病患者疗效和安全性均优于 MSII。

Efficacy and safety of continueing subcutaneous insulin infusion in gestational diabetes mellitus

Objective To study efficacy and safety of continueing subcutaneous insulin infusion (CSII) on gestational dia-betes mellitus. Methods 64 cases with GDM were randomized into CSII (n=32) and MSII (n=32) group and treated for two months. FPG、2hPG、HbA1C、24h blood glucose fluctuation and hypoglycemic events were compared between pre- and post-treatment. Results (1) After treatment, the levels of FPG and HbA1C were significantly lower than before treatment between two groups, but there was no statistically significant differences between the two groups; (2) The MAGE、SDBG、MODD indexes in 24h were lower in CSII group than in MSII group,[MAGE:(1.9±0.5) VS (2.2±0.4) mmol/L;SDBG:(2.1±0.3) VS (2.4±0.4) mmol/L;MODD:(3.3±1.4) VS (4.1±1.5) mmol/L,P<0.05];(3) The incidence of hypoglycemia was lower in CSII group than in MSII group, both two groups had no severe hypoglycemia events. Conclusion Efficacy and safety of CSII is better in CSII than in MSII in GDM with greater fluctuation in blood sugar.