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| Effects of metformin combined with insulin aspart for treating pregnant women with gestational diabetes mellitus on their pregnancy outcomes and their levels of nesfatin-1 and irisin |
| Hai'an People's Hospital, Jiangsu Province, 226600 |
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Abstract To investigate the effects of metformin combined with insulin aspart for treating pregnant women with gestational diabetes mellitus (GDM) on their pregnancy outcomes and their levels of nesfatin-1 and irisin. Methods: In this random and double-blind control trial, 120 pregnant women with GDM were selected and randomly divided into the control group (n=60) and observation group (n=60) by random number table method from January 2018 to January 2019. The women in the control group were treated with insulin aspart, while the women in the observation group were treated with metformin. The indexes of metabolic blood glucose, islet β cell function index, and serum nesfatin-1 and Irisin levels of the women in the two groups were detected. The pregnancy outcomes and adverse reactions situation of the women were compared between the two groups. Results: After treatment, the levels of fasting blood glucose, 2h postprandial blood glucose, and hba1c of the women in the two groups had decreased significantly, and which of the women in the observation group were significantly lower than those of the women in the control group (P＜0.05). The fasting insulin level and insulin resistance index value of the women in the two groups after treatment had decreased significantly, and the values of insulin secretion index and insulin sensitivity index of the women in the two groups after treatment had increased significantly, and the degrees of the change of which of the women in the observation group were significantly more than those of the women in the control group (all P＜0.05). The rates of cesarean section, hyperhydramnios, and premature delivery of the women, and the rates of macrosomia, neonatal jaundice, and neonatal hypoglycemia in the observation group were significantly lower than those of the women in the control group (all P＜0.05). There was no significant difference in the incidence of adverse reactions (21.7% vs.15.0%) of the women between the two groups (P＞0.05). After treatment, the level of serum nesfatin-1 of the women in the two groups had decreased significantly, and the level of serum Irisin of the women in the two groups had increased significantly, and the levels of serum nesfatin-1 and Irisin (1.33±0.19μg/L and 7.59±1.30 mmol/L) of the women in the observation group had significant different from those (1.71±0.25μg/L and 6.74±1.63 mmol/L) of the women in the control group (P＜0.05). Conclusion: Metformin combined with insulin aspart for treating the pregnant women with GDM can better control their blood glucose level, improve their insulin resistance and islet β cell function related indicators, and reduce the occurrence of adverse maternal and neonatal outcomes by increasing the serum nesfatin-1 level and increasing the irisin level, which has better therapeutic effect with higher safety.
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