Effects and correlation analysis of insulin injection timing on glucose and lipid metabolism,plasma D-D,AT-Ⅲ levels and pregnancy outcome in gestational diabetes mellitus patients
Objective To investigate the effects of different timing of insulin injection on glucose and lipid metabolism,plasma D-dimer(D-D),antithrombin-Ⅲ(AT-Ⅲ)level and pregnancy outcome in patients with gestational diabetes melli-tus.Methods A total of 92 patients with gestational diabetes mellitus admitted to Department of Gynecology and Obstetrics of Ganzhou Women and Children's Health Care Hospital from October 2019 to October 2022 were selected as the research objects.According to their gestational age,the patients were divided into early injection group(n=52,diagnosed and re-ceived insulin injection treatment when gestational age＜32 weeks)and late injection group(n=40,diagnosed and received insulin injection treatment when gestational age≥32 weeks),After 4 weeks of treatment,the glucose and lipid metabolism,plasma D-D,AT-Ⅲ levels and pregnancy outcomes of the two groups were compared and the correlation analysis was per-formed.Results The fasting blood glucose(FBG),two hours postprandial blood glucose(2 h PG),glycated hemoglobin(HbA1c),fasting insulin(FINS)and homeostasismodel assessment of insulin resistance(HOMA-IR)of patients in the late injection group were higher than those in the early injection group,and the differences were statistically significant(P＜0.05).The levels of triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in the late injection group were higher than those in the early injection group,and the differences were statistically significant(P＜0.05).The level of high-density lipoprotein cholesterol(HDL-C)in the late injection group was lower than that in the early injection group,and the difference was statistically significant(P＜0.05).The plasma levels of D-D and AT-Ⅲ in the late injection group were higher than those in the early injection group,and the difference were statistically significant(P＜0.05).The total incidence of adverse pregnancy outcome in the late injection group was higher than that in the early injection group,and the difference was statistically significant(P＜0.05).Pearson correlation analysis showed that,2 h PG level,HOMA-IR,FBG,HbA1c,FINS,TG,plasma D-D and AT-Ⅲ levels were negatively correlated with the timing of insulin injection(r=-0.723,-0.901,-0.473,-0.513.-0.804,-0.334,-0.702,-0.478,P＜0.05).There were no correlations between the levels of HDL-C and LDL-C and the timing of insulin injection(P＞0.05).Conclusion The glucose and lipid metabolism indexes,plasma D-D and AT-Ⅲ levels of patients receiving insulin injection in early pregnancy are lower than those of patients receiving insulin injection in late pregnancy,and correlation analysis has verified that there are fewer adverse pregnancy outcomes in patients receiving insulin injection in early pregnancy,and insulin injection in early pregnancy can reduce adverse pregnancy outcomes in patients with gestational diabetes mellitus.
Gestational diabetes mellitusPregnancy outcomeGlucose and lipid metabolismCorrelation analysis
万方数据
维普
