Effect of metformin combined with menopausal insulin in the treatment of diabetes mellitus in middle and late pregnancy and its effect on patients'serum placental growth factor,homocysteine and insulin-like growth factor-1
Objective To investigate the clinical effect of metformin combined with menthyl insulin in the treatment of mid-to late-gestational diabetes mellitus(GDM)and the effect on patients'serum placental growth factor(PLGF),homocysteine(Hcy),and insulin-like growth factor-1(IGF-1).Methods A total of 140 cases of middle and advanced GDM patients admitted to the Linping District Maternal and Child Health Care Hospital from January 2020 to December 2023 were included in the study.Based on different intervention methods and the principle of voluntariness,the patients were evenly divided into a control group and an observation group,with 70 patients in each group.The control group was treated with menthol insulin,and the observation group was treated with metformin on the basis of the control group.The serum markers,improvement in blood glucose and islet function,adverse reactions,and pregnancy outcomes were compared between the two groups.Results PLGF and IGF-1 increased and Hey decreased in both groups compared with the pre-treatment period,and PLGF(142±20)pg/ml and IGF-1(25.2±1.1)ng/ml in the observation group were higher than those in the control group(133±20)pg/ml and(24.1±1.0)ng/ml,and Hey(8.0±2.3)μmol/L in the observation group was lower than that in the control group(10.0±2.8)μmol/L low(t=2.678,6.165,4.558,all P＜0.05).Fasting blood glucose(FPG),glycated haemoglobin(HbA1c),and insulin resistance index(HOME-IR)were lower in both groups after treatment compared with before treatment,and were lower in the observation group(5.4±1.5)mmol/L,(5.7±1.0)％,and(2.3±0.4)than in the control group(6.1±1.1)mmol/L,(6.1±0.8)％,(3.1±0.5)(t=2.933,2.820,10.912,all P＜0.05).There was no significant difference between the two groups in terms of hypoglycaemia,gastrointestinal discomfort,skin reactions adverse reactions,10.0％compared to 5.7％(x2=0.888,P＞0.05).The incidence of preterm delivery,fetal distress,macrosomia,and neonatal hypoglycaemia in the observation group was 5.7％lower than that in the control group 17.1％(x2=4.516,P＜0.05).Conclusion Metformin combined with menthol insulin treatment in GDM in middle and late pregnancy can increase serum PLGF,IGF-1 levels,reduce serum Hcy and blood glucose levels,improve pancreatic islet function,reduce the incidence of preterm delivery,fetal distress and other adverse pregnancy outcomes,and is safe and reliable.
Diabetes,gestationalMetforminInsulinaspartPlacenta growth factorHomocysteineInsulin-like growth factor I
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