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| Efficacy of dynamic monitoring glucose combined with insulin pump infusion for treating pregnant women with gestational diabetes mellitus and its influence on the control effect of glucose and lipid metabolism of the women |
| Nanjing Tongren Hospital Affiliated to School of Medicine, Southeast University, Jiangsu Province, 211102 |
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Abstract To explore the efficacy of dynamic monitoring glucose combined with insulin pump infusion for treating pregnant women with gestational diabetes mellitus (GDM), and to study its influence on the control effect of glucose and lipid metabolism of the women.Methods: A total of 226 pregnant women with GDM who had received dynamic monitoring glucose were selected and randomly divided into control group and observation group (113 cases in each group) from October 2019 to June 2020.The women in the control group were given insulin by multiple daily injections (MDI), and the women in the observation group were given insulin pump infusion.The blood glucose control effect of the women was compared between the two groups.The levels of fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA1c), the values of insulin resistance index (HOMA-IR) and mean amplitude of glycemic excursions (MAGE), the percentages of time for hypoglycemia and time for hyperglycemia, and the levels of total cholesterol (TC), triglycerides (TG), highdensity lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) of the women were compared between the two groups.The indexes of serum adiponectin (APN), fatty acid binding protein 4 (FABP4), and chemotactic (Chemerin) of the women in the two groups were detected.The pregnancy outcomes and the perinatal outcomes of the women in the two groups were followed up.Results: After treatment, insulin dosage (31.02±5.01 U/d) and the time of blood glucose level returned to normal (3.31±0.59 d) of the women in the observation group were significantly lower than those (36.74±8.12U/d and 3.94±0.73 d) of the women in the control group.The rate of reaching the standard of HbA1c (69.9%) of the women in the observation group during 34 gestational weeks was significantly higher than that (54.9%) of the women in the control group.The levels of FPG, 2H PG, HbAlc, MAGE, the HOMA-IR value, the ratio of hyperglycemia, and the levels of serum hypoglycemia, TG, TC, LDL-C, FABP4, and Chemerin of the women in the observation group were significantly lower than those of the women in the control group, while the APN level of the women in the observation group was significantly higher (all P＜0.05).The incidences of hypertension, premature delivery, postpartum infection, perinatal asphyxia, and neonatal hypoglycemia of the women in the observation group were significantly lower than those of the women in the control group (P＜0.05).Conclusion: Dynamic monitoring glucose combined with insulin pump for treating the pregnant women with GDM can improve their effect of blood sugar control and pregnancy outcomes by regulating glucose and lipid metabolism indexes and adipocytokines.
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