Abstract：Objective To explore the effect of insulin on glucose metabolism in patients with gestational diabetes mellitus（GDM）at 30 weeks and more than 30 weeks of gestation. Methods A total of 96 patients with GDM were selected and divided into observation group and control group according to the different gestational weeks,with 48 cases in each group.The time point of insulin use in the observation group was ≥30 weeks of pregnancy,and the time point of insulin use in the control group was<30 weeks of pregnancy.Blood glucose levels,pregnancy outcomes,neonatal outcomes,and neonatal Apgar scores were collected and recorded in both groups. Results After treatment,the blood glucose level（fasting blood glucose,2h postprandial blood glucose,hemoglobin protein）of patients was significantly lower than that before treatment,and the blood glucose level of observation group was significantly higher than that of control group（P<0.05）.The incidence of preterm birth and pregnancy hypertension in the observation group was significantly higher than that in the control group（P<0.05）.There was no statistical significance in the incidence of cesarean section and hydramnios between the two groups（P>0.05）.The incidence of neonatal hypoglycemia,neonatal asphyxia and low body weight in the observation group was significantly higher than that in the control group,and the Apgar score in the observation group was significantly higher than that in the control group（P<0.05）.There was no statistical significance in the incidence of macrosomia between the two groups（P>0.05）. Conclusion Compared with 30 weeks before gestation,the use of insulin at 30 weeksand more than 30 weeks of gestation has relatively low improvement in blood glucose levels and maternal and infant outcomes in GDM patients.Clinically,GDM patients should be injected with insulin before 30 weeks of gestation.
贺秀锦, 宋红艳. 孕30周及超过30周使用胰岛素对妊娠期糖尿病患者糖代谢的影响[J]. 哈尔滨医药, 2022, 42(6): 48-50.
He Xiujin, Song Hongyan. Effects of Insulin on Glucose Metabolism in Patients With Gestational Diabetes Mellitus at 30 Weeks and More Than 30 Weeks of Gestation. journal1, 2022, 42(6): 48-50.
[1] 李玉琴. 妊娠期糖尿病的规范化治疗对妊娠结局的影响[J].中国现代医学杂志,2018,28(7):124-126. [2] 刘庆,蔡雯,张瑞晴,等.妊娠期糖尿病与口服葡萄糖耐量试验血糖正常孕妇胰岛素释放试验及血脂相关性研究[J].实用妇产科杂志,2020,36(5):368-372. [3] 叶华莹,李华萍.妊娠期糖尿病孕妇血脂与血糖状态及胰岛素抵抗的相关性分析[J].上海交通大学学报(医学版),2019,39(7):768-773. [4] 殷秀敏,历广招,聂立婷,等.不同治疗方式对妊娠期糖尿病母婴结局影响的Meta分析[J].中国糖尿病杂志,2020,28(6):415-422. [5] 吴杭玉,叶梅,张宜生.妊娠期糖尿病的研究进展[J].浙江医学,2018,40(13):1512-1515. [6] Mcmanus R,Miller D,Mottola M,et al.Translating healthy living messages to postpartum women and their partners after gestational diabetes(GDM):body habitus,A1C,lifestyle habits,and program engagement results from the families defeating diabetes(FDD)randomized trial[J].Am J Health Promot,2018,32(6):1438-1487. [7] 赵明,李光辉.妊娠期糖尿病孕妇的胰岛素抵抗和胰岛β细胞功能与巨大儿的相关性研究[J].中华内分泌代谢杂志,2019,35(10):848-852. [8] 郝丽萍,杨明鲜.妊娠期糖尿病的相关危险因素分析及其对母婴结局的影响[J].中国妇幼保健,2019,34(4):746-748. [9] Xi MZ,Xue L,Chen C.Longer-term outcomes in offspring of GDM mothers treated with metformin versus insulin[J].Diabetes Res Clin Pract,2018,33(07):148-166. [10] Fakhrul-Alam M,Sharmin J,Mashfiqul H,et al.Insulin secretory defect may be the major determinant of GDM in lean mothers[J].J Clin Transl Endocrinol,2020,20(12):100-226. [11] 高翠君,黄新梅,陈灶萍,等.妊娠早期血红蛋白水平与发生妊娠期糖尿病的相关性分析[J].中华妇产科杂志,2019,54(10):654-659. [12] 张静,高冬冬,谢书红,等.黄芪四君子汤联合胰岛素治疗妊娠糖尿病的疗效及影响妊娠结局的COX回归多因素分析[J].中华中医药学刊,2018,36(9):2273-2276. [13] 张宁娟,李华萍,赵芳.妊娠期胰岛素分泌模式及其他因素与新生儿出生体质量的相关因素分析[J].实用妇产科杂志,2018,34(6):439-445.
2022, Vol. 42 
