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| Analysis of the Effect of High Dose of Vitamin D Injection Combined with Insulin Aspart Injection on Parathyroid Hormone Level, Insulin Sensitivity and Maternal and Infant Outcomes in Gestational Diabetes Mellitus |
| YANG Kun, WEI Jiaxi, et al |
| The Central Hospital of Suining, Sichuan Suining 629000, China |
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Abstract Objective: To study the effect of high dose of vitamin D injection combined with injection of insulin aspart on the parathyroid hormone level, insulin sensitivity and maternal and infant outcomes in the treatment of gestational diabetes mellitus (GDM). Methods: 238 gestational diabetes patients selected as object were divided them into two groups, called control group (n=109 cases) and research group (n=129 cases) by digital table. The patients of control group were treated by insulin aspart combined with low dose of vitamin D, while the patients of research group were treated by insulin aspart combined with high dose of vitamin D. the parathyroid hormone related indexes , insulin sensitivity related indexes, vitamin D level, maternal and infant outcomes and incidence of hypoglycemia during pregnancy of two groups were compared. Results: The iPTH, product of calcium and phosphorus , phosphorus, calcium of two groups before treatment had no statistically difference (P>0.05),after treating four weeks the iPTH, product of calcium and phosphorus, phosphorus of research group were much less than control group (P<0.05),the calcium of two groups had no statistically difference (P>0.05). The iPTH, product of calcium and phosphorus, phosphorus of two groups after four weeks' treatment were all much less than pre-treatment respectively (P<0.05),while calcium of two groups after treatment had no statistically difference with pre-treatment respectively (P>0.05). The FPG, FINS, 2hPG of two groups before treatment had no statistically difference (P>0.05); the FPG, FINS, 2hPG of research group had no statistically difference with control group (P>0.05); The FPG, FINS, 2hPG of two groups after four weeks' treatment were all much less than pre-treatment respectively (P<0.05). The HOMA-βand HOMA-IR of two groups before treatment had no statistically difference (P>0.05), the HOMA-βof research group after treatment was much higher than control group. HOMA-IR much less than control group (P<0.05). The HOMA-βand HOMA-IR of two groups after four weeks' treatment were all much less than pre-treatment respectively (P<0.05). The vitamin D level of two groups before treatment had no statistically difference (P>0.05). The moderate lack rate of research group after treatment was less than control group (P<0.05). The normal rate of research group after treatment was more than control group(P<0.05); the slight lack rate of research group after treatment of two groups had no statistically difference (P>0.05). The moderate lack rate and slight lack rate of two groups after four weeks' treatment were all much less than pre-treatment respectively (P<0.05); normal rate was much higher than pre-treatment respectively (P<0.05). The rate of maternal and infant outcomes and hypoglycemia of research group was 20.93%, while control group was 31.19%; they had statistically difference (P<0.05). Conclusion: High dose of vitamin D injection combined with injection of insulin aspart in the treatment of GDM can prevent the occurrence of physiological hyperparathyroidism in late pregnant period ,increase the insulin sensitivity, effectively control blood sugar and improve the deficiency degree of vitamin D, and definite effect, decrease maternal and neonatal complications rate, which is worthy of being clinically promoted.
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2017, Vol. 23 
