Clinical effect of vitamin D combined with insulin aspart injection for treating women with gestational diabetes mellitus
Objective:To explore the clinical effect of vitamin D combined with insulin aspart injection(novorapid)for treating pregnant women with gestational diabetes mellitus(GDM).Methods:114 pregnant women with GDM were selected and were divided into two groups(57 cases in each group)by the random number table method from January 2020 to January 2023.The women in the two groups were treated with insulin aspart injection continuously until the blood glucose reached the standard,while the women in the study group was given vitamin D additionally.The levels of blood glucose indicators,such as fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG),and HbA1c,the insulin indicators,such as fasting insulin(FINS)level,and the values of homeostasis model assessment(HOMA)of islet β cell function and HOMA-insulin resistance(IR),the levels of blood lipids,such as plasma fatty acid,total cholesterol and triglyceride,the levels of homocysteine(Hey),the Toll-like receptor 4(TLR4)and vascular cell adhe-sion molecule(VCAM-1)of the women before treatment and before delivery were compared between the two groups.The maternal and infant outcomes in the two groups were followed up.Results:The levels of FPG,2hPG and HbA1c after treatment of the women in the two groups before delivery had decreased significantly(P＜0.05),but which of the women had no significant difference between the two groups(P＞0.05).The FINS level and the HOMA-IR value of the women in the two groups after treatment had decreased significantly,and the HOMA-β value of the women in the two groups after treatment had increased significantly,and which(12.76±1.46μU/ml,2.98±0.23 and 89.52±8.10)of the women in the study group were significantly better than those(12.87±1.52μU/ml,3.30±0.52 and 81.41±8.08)of the women in the control group.The blood lipid indexes levels of the women in the two groups after treatment had decreased significantly,and which of the women in the study group were significantly lower than those of the women in the control group.The levels of TLR4,VCAM-1 and Hcy of the women in the two groups after treatment had decreased significantly,and which(6.71±1.38 mU/L,43.63±7.47 ng/ml and 8.47±1.85μmol/L)of the women in the study group were significantly lower than those(8.49±1.46 mU/L,52.47±7.63 ng/ml and 11.21±2.76μmol/L)of the women in the control group(all P＜0.05).There was no significant difference in the incidence of the adverse maternal and neonatal outcomes(14.0％vs.8.8％)of the women between the two groups(P＞0.05).Conclusion:Vi-tamin D supplemented with insulin aspart injection for treating the pregnant women with GDM is beneficial to impro-ving their insulin resistance and lipid metabolism,and which can inhibit the expressions of pro-inflammatory factors,such as Hcy,of the women,and without increasing the risk of the adverse maternal and infant outcomes.
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