Abstract：Objective To investigate the effect of Insulin Aspart Injection in the treatment of patients with gestational diabetes mellitus (GDM). Methods A total of 120 GDM patients admitted to Obstetrics and Gynecology Department of Huai’an First Hospital Affiliated to Nanjing Medical University from February 2016 to October 2018 were selected as research objects, and they were divided into combined group and control group of 60 cases by using a random number table. Both groups were given Metformin for glucose control, and combined group was given Insulin Aspart. After three months of continuous treatment, fasting blood glucose (FPG), two-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), cystatin C (Cys-C), homocysteine (Hcy), N-acetyl-β-D-glucosidase (NAG), urinary microalbumin (mALB), pregnancy complications and delivery were compared between two groups before and after intervention. Results After intervention, the levels of FPG, 2hPG and HbA1c in two groups were lower than those before intervention, and those in combined group were lower than those in control group (P < 0.05). After intervention, Cys-C, Hcy, NAG and mALB levels in two groups were lower than those before intervention, and those in combined group were lower than those in control group (P < 0.05). There were no significant differences in the incidence rates of polyhydramnios, hypoglycemia and cesarean section between two groups (P > 0.05). The incidence rate of macrosomia in combined group was lower than that in control group (P < 0.05). There were no significant differences in the incidence rates of neonatal jaundice, respiratory distress and neonatal hypoglycemia between two groups (P > 0.05). Conclusion Metformin combined with Insulin Aspart in the treatment of GDM has a better sugar control effect, and at the same time has a certain protective effect on renal function, which can effectively reduce the incidence of huge children.
[1] 陈龙，王曼，刘利平.妊娠期糖尿病患者血清Betatrophin含量检测及其与机体糖脂代谢紊乱的相关关系[J].海南医学院学报，2018，24（22）：1959-1962.
[2] 肖喜荣，董欣然，李笑天，等.孕妇基本特征及14～20周糖脂代谢指标对妊娠期糖尿病的早期预测价值[J].中国实用妇科与产科杂志，2018，34（4）：429-432.
[3] 王艳艳，张静文，蔡娅琼.血管内皮生长因子表达及基因多态性与妊娠期糖尿病风险的相关性[J].河北医学，2020，26（5）：868-872.
[4] Barbour LA，Hernandez TL. Maternal non-glycemic contributors to fetal growth in obesity and gestational diabetes：spotlight on lipids [J]. Curr Diab Rep，2018，18（6）：37.
[5] 李自云，刘波，庄新娟，等.黄连素对2型糖尿病患者血清胱抑素C及尿微量白蛋白/肌酐比值的影响[J].中华医学杂志，2018，98（46）：3756-3761.
[6] Chirakalwasan N，Amnakkittikul S，Wanitcharoenkul E，et al. Continuous positive airway pressure therapy in gestational diabetes with obstructive sleep apnea：a randomized controlled trial [J]. J Clin Sleep Med，2018，14（3）：327-336.
[7] Hickok RA，Waites BT，Walker AR，et al. Pregnancy outcomes in patients without gestational diabetes stratified by maternal age [J]. Obstet Gynecol，2018，131（23）：139.
[8] Buffarini R，Barros AJD，Matijasevich A，et al. Gestational diabetes mellitus，pre-gestational BMI and offspring BMI z-score during infancy and childhood：2004 Pelotas Birth Cohort [J]. BMJ Open，2019，9（7）：24734.
[9] 翟清，薛嘉睿，高家林，等.尿白蛋白排泄率与老年糖尿病视网膜病变的关系[J].中国老年学杂志，2019，18（11）：2623-2625.
[10] Kondo T，Nakamura M，Kitano S，et al. The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus：a case report [J]. BMC Endocr Disord，2018，18（1）：4.
[11] Heidari Z，Mahmoudzadeh-Sagheb H，Narouei M，et al. Effects of gestational diabetes mellitus on stereological parameters and extravillous trophoblast cells of placenta compared to the control group [J]. J Obstet Gynaecol，2019，39（7）：1-6.
[12] Hu S，Ma S，Li X，et al. Relationships of SLC2A4，RBP4，PCK1，and PI3K gene polymorphisms with gestational diabetes mellitus in a Chinese population [J]. Biomed Res Int，2019，2019（12）：1-9.
[13] 冯艳，宋新娜，徐晓萌，等.妊娠期糖尿病患者铁代谢与部分应激激素及胰岛素抵抗的关系[J].中华内分泌代谢杂志，2018，34（7）：563-566.
[14] Bublitz MH，Monteiro JF，Caraganis A，et al. Obstructive sleep apnea in gestational diabetes：a pilot study of the role of the hypothalamic-pituitary-adrenal axis [J]. J Clin Sleep Med，2018，14（1）：87-93.
[15] Basha AS，Fram KM，Thekrallah FM，et al. Prevalence of gestational diabetes and contributing factors among pregnant Jordanian women attending Jordan University Hospital [J]. Int J Diabetes Dev C，2018，39（9）：1-7.
[16] 顾熔，杨涛，顾威.长效胰岛素类似物在儿童青少年1型糖尿病治疗中的价值[J].中华内分泌代谢杂志，2019，35（4）：345-349.
[17] Gray SG，Sweeting AN，Mcguire TM，et al. The changing environment of hyperglycaemia in pregnancy：gestational diabetes and diabetes mellitus in pregnancy：changing world of hyperglycaemia in pregnancy [J]. J Diabetes，2018， 10（8）：333-337.
[18] Meloncelli N，Barnett A，Pelly F，et al. Diagnosis and management practices for gestational diabetes mellitus in Australia：cross：ectional survey of the multidisciplinary team [J]. Aust Nz J Obstet Gyn，2018，59（2）：34-36.
[19] 胡广云，马向华.双时相门冬胰岛素联合二甲双胍对2型糖尿病患者的疗效和安全性研究[J].南京医科大学学报，2019，12（6）：919-921.
[20] 陆锦昆，潘琼华，潘海林，等.甘精胰岛素与门冬胰岛素30对2型糖尿病患者胰岛β细胞功能及血糖稳定性的影响[J].广西医科大学学报，2019，36（1）：33-36.
[21] 王艳妮，张逢，胡杰，等.门冬胰岛素30强化治疗2型糖尿病对血糖、血脂、胰岛β细胞功能的影响[J].西部医学，2018，30（8）：1191-1194.
[22] 卢晓郎，余洋，余可和，等.诺和锐30与二甲双胍治疗糖尿病合并骨质疏松的疗效比较[J].中华内分泌外科杂志，2018，12（5）：404.
[23] 姚胜红，射阳.门冬胰岛素30强化治疗初诊2型糖尿病患者的临床观察及饮食控制措施[J].现代消化及介入诊疗，2018，18（2）：173.
[24] 肖磊，刘怀昌，谈炯新.门冬胰岛素治疗妊娠期糖尿病的效果及对不同时间段血糖水平的影响[J].广东医学，2018，39（z1）：228-230.
[25] 张雪莲，崔玲，罗斌，等.门冬胰岛素30与预混人胰岛素治疗中国2型糖尿病患者的Meta分析[J].中国糖尿病杂志，2018，26（9）：25-34.
[26] 薄琦.门冬胰岛素注射液联合不同剂量维生素D对妊娠期糖尿病患者血清糖化血红蛋白脂肪素水平变化及妊娠结局的影响[J].中国药物与临床，2019，19（6）：950-952.
[27] 杨凤敏.门冬胰岛素联合地特胰岛素治疗妊娠期糖尿病的临床疗效[J].中国现代医生，2019，57（33）：107-109，115.
[28] 梅周，殷应传，周晓惠，等.门冬胰岛素30联合二甲双胍治疗T2DM的临床疗效及对患者血糖及血脂水平影响的研究[J].标记免疫分析与临床，2018，25（7）：91-94
2020, Vol. 17 
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