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地特胰岛素和精蛋白生物合成人胰岛素维持妊娠合并糖尿病孕妇基础胰岛素水平的临床效果

Clinical effect of insulin detemir and protamine biosynthesis of human insulin on maintenance of basal insulin level in pregnant women with gestational diabetes mellitus

  • 摘要: 目的 分析地特胰岛素(Det)、精蛋白生物合成人胰岛素(NPH)在妊娠糖尿病中应用对血糖及基础胰岛水平的干预效果。方法 将符合本研究标准的妊娠合并糖尿病患者(80例)用随机数字表法分为两组。均给予门冬胰岛素,观察组加Det,对照组加NPH。对比两组治疗前后血糖水平及达标时间,对比两组7d时胰岛素使用情况、治疗前后空腹胰岛水平及胰岛B细胞功能。记录低血糖发生、治疗后体质量(BMI)及分娩结局。结果 观察组血糖全部达标时间较对照组短,7 d时空腹血糖(FBG)、餐后2小时血糖(2 hPG)水平及治疗后2 hPG水平更低;治疗后观察组2hPG较对照组低;观察组Det用量较对照组NPH多,但每日注射次数较对照组少;观察组治疗7d时HOMA-B较对照组高,治疗后FINS、HOMA-B、MBCI高于对照组;观察组低血糖发生率(7.50%)低于对照组(20.00%)。差异均有统计学意义(P<0.05)。两组治疗后BMI及母婴分娩结局相关指标比较,差异均无统计学意义(P>0.05)。结论 以上两种胰岛素均能有效控制妊娠合并糖尿病血糖,维持胰岛素水平,但地特胰岛素效果更明显,安全性更高。

     

    Abstract: Objective To analyze the intervention effects of Insulin Detemir Injection (Det) and Isophane Protamine Biosynthetic Human Insulin Injection (NPH) on the level of blood glucose and basal islets in gestational diabetes mellitus.Methods Patients with gestational diabetes mellitus (n=80) who met the criterias of this study were divided into observation group and control group by random number table. Insulin was provided to the two groups. The observation group and the control group were also given Det and NPH, respectively. The blood glucose level and the time to reach the standard before and after treatment between the two groups were compared. The situation of insulin usage at the 7th day, fasting insulin level (FINS), and pancreatic islet B-cell function before and after treatment between the two groups were also compared. The occurrence of hypoglycemia, body mass index (BMI) after treatment and the delivery outcomes were recorded.Results All of the time of blood glucose reaching the standard of the observation group was shorter than that of the control group. The fasting blood glucose (FBG) at the 7th day and the level of 2 hours' postprandial blood glucose (2 hPG) before and after treatment in the observation group were lower than that in the control group. Although the dosage of Det in the observation group was more than the dosage of NPH in the control group, the number of daily injections in observation group was less than in the control group. The HOMA-B at the 7th day, the FINS、HOMA-B、MBCI after treatment in the observation group were higher than in the control group. The incidence of hypoglycemia in the observation group (7.50%) was lower than that of the control group (20.00%). The difference was statistically significant (P< 0.05). After treatment, there was no statistical difference in BMI and the related indicators of maternal and child delivery outcomes between the two groups (P> 0.05).Conclusion The above two kinds of insulin can effectively control the blood sugar of pregnant women with diabetes and maintain the insulin level.However, the detemir effect is more obvious and its safety is higher.

     

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