PDF(Pubmed)
Abstract：
UNASSIGNED: To explore the clinical effect and impact of exercise-diet therapy combined with Insulin Aspart Injection on gestational diabetes mellitus (GDM).
UNASSIGNED: The objects of study were patients with pregestational diabetes mellitus (PGDM) and 62 patients with GDM who were diagnosed by oral glucose tolerance test (OGTT) and insulin release test from February 2017 to February 2019. According to the severity of the disease, enrolled patients were informed to have appropriate exercise and diet control or Insulin Aspart Injection on this basis until the completion of delivery. By using 50 pregnant women with normal glucose as the control, the fasting plasma glucose (FPG), 1-hour postprandial glucose (1hPG), 2-hour postprandial glucose (2hPG), nocturnal glucose, and glycosylated hemoglobin (HbA1c) levels were compared between the PGDM group and the GDM group before and after treatment; besides, further comparison was made in terms of glucose compliance rate, islet B-cell secretory function, and insulin resistance after treatment. The pregnant women were examined by B-ultrasound at 24 and 26 weeks of gestation to check if the fetus had abnormalities in the central nervous system and the heart. Further B-ultrasound examination was performed at 32 and 37 weeks of gestation to check the problems such as polyhydramnios and stillbirth. In addition, a comparative analysis was carried out in terms of the adverse pregnancy outcomes and complications, associated with the comparison of the results after treatment with control group.
UNASSIGNED: After treatment, the levels of FPG, 1hPG, 2hPG, nocturnal glucose, and HbA1c were decreased in the PGDM group and GDM group than those before treatment, especially in the GDM group, with significant difference still when compared with the control group (P < 0.05). Statistical analysis revealed that the blood glucose compliance rate in the GDM group was higher than that in the PGDM group, showing a better therapeutic effect. Fasting insulin (FINS) and homeostasis model assessment index for insulin resistance (HOMA-IR) in the GDM group were significantly higher than those in control group, but lower than those in the PGDM group (P < 0.01), while the level of HOMA-β was lower in the GDM group than that in the control group and higher than that in PGDM (P < 0.01). Further ultrasound examination revealed the presence of fetal cardiac abnormality, polyhydramnios, stillbirth, and problems, showing a higher incidence in the PGDM group but almost nonexistence in the control group. In addition, the incidence of hypertension, macrosomia, premature rupture of membranes, postpartum hemorrhage, and infection were obviously higher in the PGDM group than those in the GDM group and control group (P < 0.05).
UNASSIGNED: Exercise-diet therapy combined with Insulin Aspart Injection can effectively control the blood glucose level of pregnant patients with GDM, improve the pregnancy outcome to a certain extent, and ensure the health of pregnant women and fetus, which is worthy of clinical application.
UNASSIGNED: The objects of study were patients with pregestational diabetes mellitus (PGDM) and 62 patients with GDM who were diagnosed by oral glucose tolerance test (OGTT) and insulin release test from February 2017 to February 2019. According to the severity of the disease, enrolled patients were informed to have appropriate exercise and diet control or Insulin Aspart Injection on this basis until the completion of delivery. By using 50 pregnant women with normal glucose as the control, the fasting plasma glucose (FPG), 1-hour postprandial glucose (1hPG), 2-hour postprandial glucose (2hPG), nocturnal glucose, and glycosylated hemoglobin (HbA1c) levels were compared between the PGDM group and the GDM group before and after treatment; besides, further comparison was made in terms of glucose compliance rate, islet B-cell secretory function, and insulin resistance after treatment. The pregnant women were examined by B-ultrasound at 24 and 26 weeks of gestation to check if the fetus had abnormalities in the central nervous system and the heart. Further B-ultrasound examination was performed at 32 and 37 weeks of gestation to check the problems such as polyhydramnios and stillbirth. In addition, a comparative analysis was carried out in terms of the adverse pregnancy outcomes and complications, associated with the comparison of the results after treatment with control group.
UNASSIGNED: After treatment, the levels of FPG, 1hPG, 2hPG, nocturnal glucose, and HbA1c were decreased in the PGDM group and GDM group than those before treatment, especially in the GDM group, with significant difference still when compared with the control group (P < 0.05). Statistical analysis revealed that the blood glucose compliance rate in the GDM group was higher than that in the PGDM group, showing a better therapeutic effect. Fasting insulin (FINS) and homeostasis model assessment index for insulin resistance (HOMA-IR) in the GDM group were significantly higher than those in control group, but lower than those in the PGDM group (P < 0.01), while the level of HOMA-β was lower in the GDM group than that in the control group and higher than that in PGDM (P < 0.01). Further ultrasound examination revealed the presence of fetal cardiac abnormality, polyhydramnios, stillbirth, and problems, showing a higher incidence in the PGDM group but almost nonexistence in the control group. In addition, the incidence of hypertension, macrosomia, premature rupture of membranes, postpartum hemorrhage, and infection were obviously higher in the PGDM group than those in the GDM group and control group (P < 0.05).
UNASSIGNED: Exercise-diet therapy combined with Insulin Aspart Injection can effectively control the blood glucose level of pregnant patients with GDM, improve the pregnancy outcome to a certain extent, and ensure the health of pregnant women and fetus, which is worthy of clinical application.
摘要：
■探讨运动饮食联合门冬胰岛素注射液治疗妊娠期糖尿病的临床疗效及影响。
■研究对象为2017年2月至2019年2月口服葡萄糖耐量试验(OGTT)和胰岛素释放试验确诊的孕前糖尿病(PGDM)患者和GDM患者62例。根据疾病的严重程度,纳入的患者被告知在此基础上进行适当的运动和饮食控制或门冬胰岛素注射,直至分娩完成.以50名血糖正常的孕妇为对照,空腹血糖（FPG），餐后1小时葡萄糖（1hPG），2小时餐后葡萄糖（2hPG），夜间葡萄糖，比较PGDM组与GDM组治疗前后的糖化血红蛋白(HbA1c)水平;在葡萄糖达标率方面进行了进一步比较，胰岛B细胞分泌功能，治疗后胰岛素抵抗。孕妇在妊娠24周和26周时进行B超检查，以检查胎儿是否有中枢神经系统和心脏异常。在妊娠32周和37周进一步进行B超检查，以检查羊水过多和死胎等问题。此外,在不良妊娠结局和并发症方面进行了比较分析，与对照组治疗后的结果比较。
■治疗后，FPG的水平，1hPG,2hPG，夜间葡萄糖，PGDM组和GDM组HbA1c较治疗前下降,特别是在GDM组中，与对照组相比仍有显著性差异(P<0.05)。统计学分析显示GDM组的血糖达标率高于PGDM组,显示出更好的治疗效果。GDM组空腹胰岛素(FINS)和胰岛素抵抗稳态模型评估指数(HOMA-IR)均显著高于对照组,但低于PGDM组（P<0.01），GDM组的HOMA-β水平低于对照组，高于PGDM组（P<0.01）。进一步超声检查发现胎儿心脏异常,羊水过多,死产,和问题，PGDM组发病率较高，但对照组几乎不存在。此外,高血压的发病率，巨大儿,胎膜早破,产后出血,PGDM组感染率明显高于GDM组和对照组(P<0.05)。
■运动饮食疗法联合门冬胰岛素注射液可有效控制妊娠合并GDM患者的血糖水平，在一定程度上改善了妊娠结局,确保孕妇和胎儿的健康，值得临床推广应用。
■研究对象为2017年2月至2019年2月口服葡萄糖耐量试验(OGTT)和胰岛素释放试验确诊的孕前糖尿病(PGDM)患者和GDM患者62例。根据疾病的严重程度,纳入的患者被告知在此基础上进行适当的运动和饮食控制或门冬胰岛素注射,直至分娩完成.以50名血糖正常的孕妇为对照,空腹血糖（FPG），餐后1小时葡萄糖（1hPG），2小时餐后葡萄糖（2hPG），夜间葡萄糖，比较PGDM组与GDM组治疗前后的糖化血红蛋白(HbA1c)水平;在葡萄糖达标率方面进行了进一步比较，胰岛B细胞分泌功能，治疗后胰岛素抵抗。孕妇在妊娠24周和26周时进行B超检查，以检查胎儿是否有中枢神经系统和心脏异常。在妊娠32周和37周进一步进行B超检查，以检查羊水过多和死胎等问题。此外,在不良妊娠结局和并发症方面进行了比较分析，与对照组治疗后的结果比较。
■治疗后，FPG的水平，1hPG,2hPG，夜间葡萄糖，PGDM组和GDM组HbA1c较治疗前下降,特别是在GDM组中，与对照组相比仍有显著性差异(P<0.05)。统计学分析显示GDM组的血糖达标率高于PGDM组,显示出更好的治疗效果。GDM组空腹胰岛素(FINS)和胰岛素抵抗稳态模型评估指数(HOMA-IR)均显著高于对照组,但低于PGDM组（P<0.01），GDM组的HOMA-β水平低于对照组，高于PGDM组（P<0.01）。进一步超声检查发现胎儿心脏异常,羊水过多,死产,和问题，PGDM组发病率较高，但对照组几乎不存在。此外,高血压的发病率，巨大儿,胎膜早破,产后出血,PGDM组感染率明显高于GDM组和对照组(P<0.05)。
■运动饮食疗法联合门冬胰岛素注射液可有效控制妊娠合并GDM患者的血糖水平，在一定程度上改善了妊娠结局,确保孕妇和胎儿的健康，值得临床推广应用。
