Effect of protamine biosynthetic human insulin and insulin detemir combined with insulin aspart on gestational diabetes mellitus(GDM):an observational study
Objective To explore the impact of protamine biosynthetic human insulin and insulin detemir combined with insu-lin aspart on the glycometabolism and maternal and infant outcomes in pregnant women with gestational diabetes mellitus(GDM),in order to provide a reference for clinical treatment.Methods This study selected 120 GDM pregnant worhen ad-mitted to Suining Municipal Hospital from January 2021 to December 2023 as research participants.pregnant worhen were randomly assigned to an observation group and a control group,with 60 cases in each group.Both groups of pregnant women were treated with insulin aspart.The control group was treated with protamine biosynthetic human insulin in addi-tion to insulin aspart;the observation group was treated with insulin detemir in addition to insulin aspart.Both groups of pregnant women were treated for 2 weeks as one course,and the changes in blood glucose control levels[fasting plasma glu-cose(FPG),glycated hemoglobin(HbA1c),2-hour postprandial blood glucose(2hFPG)],blood lipid level indicators[to-tal cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and in-sulin-related indicators[homeostasis model assessment of insulin resistance(HOMA-IR),homeostasis model assessment of β-cell function(HOMA-β),fasting insulin(FINs)]were compared before and after 4 courses of treatment.The incidence of hy-poglycemic events and maternal and infant outcomes in the two groups of pregnant women was compared.Results Before treatment,there was no statistically significant difference in FPG,2h-PBG,or HbA1c levels between the two groups of pregnant women(P＞0.05).After 4 courses of treatment,the levels of FPG,2h-PBG,and HbA1c in both groups of preg-nant women were lower than before treatment,and the observation group was lower than the control group,with statistical-ly significant differences(P＜0.05).Before treatment,no significant differences were found in TC,LDL-C,or HDL-C lev-els between the two groups of pregnant women(P＞0.05).After 4 courses of treatment,the levels of TC,and LDL-C in both groups of pregnant women were significantly lower than before treatment,and the observation group was significantly lower than the control group(P＜0.05).After 4 courses of treatment,the levels of HDL-C in both groups of pregnant women were significantly higher than before treatment,and the observation group was significantly higher than the control group(P＜0.05).Before treatment,no statistically significant differences were observed in HOMA-IR,HOMA-β,or FINs levels between the two groups of pregnant women(P＞0.05).After 4 courses of treatment,the levels of HOMA-IR and FINs in both groups of pregnant women were significantly lower than before treatment,and the observation group was significantly lower than the control group(P＜0.05).After 4 courses of treatment,the levels of HOMA-β in both groups of pregnant women were significantly higher than before treatment,and the observation group was significantly higher than the control group(P＜0.05).No statistically significant difference was noted in the incidence of hypoglycemic events be-tween the two groups of pregnant women(P＞0.05).No statistically significant differences were found in the incidence of cesarean section,premature rupture of membranes,and total incidence between the two groups of pregnant women(P＞0.05).No statistically significant differences were observed in the incidence of preterm birth,hyperbilirubinemia,macroso-mia,and total incidence in the two groups of newborns(P＞0.05).Conclusion Insulin detemir combined with insulin as-part can effectively strengthen the blood glucose and blood lipid levels in GDM pregnant women,restore the function of pan-creatic β-cells,promote clinical efficacy,and does not increase the risk of hypoglycemia and adverse pregnancy outcomes,justifying a wider promotion.
Human insulinInsulin detemirGestational diabetes mellitusGlucose-lipid metabolismPregnancy outcome
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维普
