OBJECTIVE: To evaluate the comparative impacts of continuous subcutaneous insulin infusion (CSII).
METHODS: Based on the treatment modality received, the patients were allocated into two cohorts: The CSII group and the multiple daily injections (MDI) group, with each cohort comprising 210 patients. Comparative assessments were made regarding serum levels of serum-secreted frizzled-related protein 5, homocysteine, and C1q/TNF-related protein 9. Furthermore, outcomes such as fasting plasma glucose, 2-hour postprandial glucose levels, pain assessment scores, and the incidence of complications were evaluated post-treatment.
RESULTS: The CSII group displayed notably lower fasting plasma glucose and 2-h postprandial glucose levels in comparison to the MDI group (P < 0.05). Subsequent analysis post-treatment unveiled a significantly higher percentage of patients reporting no pain in the CSII group (60.00%) in contrast to the MDI group (36.19%) (P < 0.05). Additionally, the CSII group exhibited a markedly reduced occurrence of fetal distress and premature rupture of membranes compared to the MDI group (P < 0.05). However, there were no significant variances observed in other pregnancy outcomes between the two groups (P > 0.05). A statistical analysis revealed a significant difference in the incidence of complications between the groups (χ 2 = 11.631, P = 0.001).
CONCLUSIONS: The utilization of CSII via an insulin pump, as opposed to MDI, can significantly enhance the management of insulin administration in patients with GDM by diversifying the sites of insulin delivery. This approach not only promotes optimal glycemic control but also regulates metabolic factors linked to blood sugar, reducing the likelihood of adverse pregnancy outcomes and complications. The clinical relevance and importance of CSII in GDM management highlight its wide-ranging clinical usefulness.
目的:评估持续皮下胰岛素输注(CSII)的比较效果。
方法:根据所接受的治疗方式,将患者分为两组:CSII组和每日多次注射(MDI)组,每个队列包括210例患者。对血清分泌的卷曲相关蛋白5,同型半胱氨酸的血清水平进行了比较评估,和C1q/TNF相关蛋白9。此外,结果如空腹血糖,2小时餐后葡萄糖水平,疼痛评估评分,治疗后评估并发症的发生率。
结果:与MDI组相比,CSII组的空腹血糖和餐后2小时血糖水平明显降低(P<0.05)。治疗后的后续分析显示,与MDI组(36.19%)相比,CSII组(60.00%)没有疼痛的患者比例明显更高(P<0.05)。此外,与MDI组相比,CSII组的胎儿窘迫和胎膜早破发生率明显降低(P<0.05)。然而,两组其他妊娠结局差异无统计学意义(P>0.05)。经统计学分析,两组并发症发生率差异有统计学意义(χ2=11.631,P=0.001)。
结论:通过胰岛素泵使用CSII,与MDI相反,通过使胰岛素给药部位多样化,可以显着增强GDM患者的胰岛素给药管理。这种方法不仅可以促进最佳的血糖控制,还可以调节与血糖相关的代谢因素。降低不良妊娠结局和并发症的可能性。CSII在GDM管理中的临床意义和重要性突出了其广泛的临床实用性。