胰岛素类似物在妊娠合并糖尿病中的应用

在妊娠合并糖尿病患者的治疗中，基础一餐时胰岛素治疗作为一种安全有效的治疗方案，是妊娠期首选的降糖治疗方案。门冬胰岛素和人胰岛素作为餐时治疗胰岛素安全有效，相比人胰岛素，门冬胰岛素有起效快、低血糖发生率低、餐时血糖管理更加灵活方便等优势。中性鱼精蛋白锌胰岛素（NPH），因其变异度大、半衰期短的特性影响了其疗效和安全性。最近发布的临床试验显示，地特胰岛素作为基础胰岛素，在妊娠期间胰岛素强化治疗中，具有与NPH相当的安全性和耐受性，并且在妊娠晚期空腹血糖的控制方面具有一定的优势，为妊娠合并糖尿病患者的治疗提供了更好的选择。

Clinical application of insulin analogs in diabetes and pregnancy

Basal-bolus insulin regimen is the gold standard for diabetes during pregnancy. The development of rapid-acting insulin analogues, such as insulin aspart, has provided greater choice for patients, with the potential benefits of less hypoglycemia and allows for more flexibility in mealtime administration than human insulins. The latest clinical trials show that as the basal insulin, th6 safety and tolerability of insulin detemir in intensive therapy are comparable with NPH insulin, but the former is more effective in decreasing fasting glucose concentrations in late pregnancy, which provides better choices for the treatments of diabetes during pregnancy.