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| Effect of blood glucose control and perinatal outcomes of metformin combined with insulin for treating pregnant women with gestational diabetes mellitus |
| Guang'an Hospital of West China, Sichuan University, Guang'an, Sichuan Province, 638000 |
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Abstract To explore the effect of blood glucose control of metformin combined with insulin for treating pregnant women with gestational diabetes mellitus (GDM), and to study the perinatal outcomes of the women. Methods: A total of 104 pregnant women with GDM were selected and were divided into study group (52 women were given metformin combined with insulin therapy) and control group (52 women were given insulin therapy alone) according to the random number table method between December 2018 and January 2020. The levels of blood glucose control indexes, such as fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), and glycosylated albumin (GA), of the women at different pregnant stage were compared between the two groups. The levels of the indexes of islet function, such as homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment ofβinsulin secretion (HOMA-β), the levels of inflammatory factors, such as acute phase serum amyloid A (ASAA) and interleukin-6 (IL-6), and the levels of disease-related factors, such as glucagon-like peptide-1 (GLP-1) and omentin-1, of the women in the two groups were compared between before and after pregnancy, and between before and after delivery. The values of perinatal outcomes and medication safety indexes of the women in the two groups were compared between before and after pregnancy, and between before and after delivery. Results: After treatment, the levels of FBG, 2hPG, HbA1c, and GA of the women in the study group during the first trimester of pregnancy were significantly lower than those of the women in the control group (P<0.05), but which of the women during the second and third trimester of pregnancy had no significant different between the two groups (P>0.05). The HOMA-IR value and the levels of inflammatory factors of the women in the two groups before delivery were significantly lower than those before treatment, while the HOMA-β values and the disease-related factors levels of the women in the two groups before delivery were significantly higher than before treatment (all P<0.05), but which of the women all had no significant different between the two groups (P>0.05). The incidences of the low birth weight infants (3.9%) and the neonatal hypoglycemia (11.5%) in the study group were significantly lower than those (17.3% and 30.8%) in the control group (P<0.05), but there were no significant differences in the incidences of cesarean section, premature delivery, pregnancy complications, macrosomia, and other neonatal complications between the two groups (P>0.05). There was no significant difference in the classification of medication safety of the women between the two groups (P>0.05). Conclusion: Metformin combined with insulin for treating the women with GDM during the first trimester of pregnancy has better blood glucose control effect, and which can improve the perinatal outcomes of these women.
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