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中华产科急救电子杂志 ›› 2021, Vol. 10 ›› Issue (01) : 20 -24. doi: 10.3877/cma.j.issn.2095-3259.2021.01.005

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妊娠期高血糖胰岛素应用的种类、特点和技巧
罗恒聪1, 张莹1,()   
  1. 1. 510150 广州医科大学附属第三医院内分泌代谢科
  • 收稿日期:2020-11-16 出版日期:2021-02-18
  • 通信作者: 张莹

The types, characteristics, and application techniques of insulin in gestational hyperglycemia

Hengcong Luo1, Ying Zhang1()   

  • Received:2020-11-16 Published:2021-02-18
  • Corresponding author: Ying Zhang
引用本文:

罗恒聪, 张莹. 妊娠期高血糖胰岛素应用的种类、特点和技巧[J]. 中华产科急救电子杂志, 2021, 10(01): 20-24.

Hengcong Luo, Ying Zhang. The types, characteristics, and application techniques of insulin in gestational hyperglycemia[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2021, 10(01): 20-24.

妊娠期高血糖包括妊娠期糖尿病、妊娠期显性糖尿病及孕前糖尿病。妊娠期高血糖患病率高,且与不良妊娠结局明确相关。迄今为止,我国尚未批准任何口服降糖药物用于妊娠期高血糖的治疗,胰岛素是妊娠期间控制血糖的首选。随着胰岛素类似物应用,妊娠期可选用的胰岛素越来越多。本文将对妊娠期间高血糖的特点、胰岛素应用种类及特点和应用技巧进行概述。

Gestational hyperglycemia includes gestational diabetes mellitus (GDM), overt diabetes mellitus (ODM) and pre-gestational diabetes mellitus (PGDM). The prevalence of hyperglycemia during pregnancy is high and clearly related to adverse pregnancy outcomes. So far, China has not approved any oral hypoglycemic drugs for the treatment of hyperglycemia during pregnancy. Insulin is the first choice for blood glucose control during pregnancy. With the application of insulin analogues, more and more type of insulins can be used during pregnancy. This article will summarize the characteristics of hyperglycemia during pregnancy, the types, characteristics, and application techniques of insulin applications.

[1]
中华医学会糖尿病学分会.中国2型糖尿病防治指南 (2017年版)[J]. 中国实用内科杂志, 2018, 38(4): 292-344.
[2]
HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes[J]. N Engl J Med, 2008, 358(19): 1991-2002.
[3]
杨慧霞. 妊娠合并糖尿病:临床实践指南 [M]. 2版. 北京:人民卫生出版社,2013: 1-337
[4]
Blum AK. Insulin use in pregnancy: an update [J]. Diabetes Spectr, 2016, 29(2): 92-97.
[5]
Hod M, Damm P, Kaaja R, et al. Fetal and perinatal outcomes in type 1 diabetes pregnancy: a randomized study comparing insulin aspart with human insulin in 322 subjects [J]. Am J Obstet Gynecol, 2008, 198(2): 186. e1-e7.
[6]
Aydin Y, Berker D, et al. Is insulin lispro safe in pregnant women: does it cause any adverse outcomes on infants or mothers? [J]. Diabetes Res Clin Pract, 2008, 80(3): 444-448.
[7]
Lv S, Wang J, Xu Y. Safety of insulin analogs during pregnancy: a meta-analysis [J]. Arch Gynecol Obstet, 2015, 292(4): 749-756.
[8]
Kurtzhals P, Schaffer L, Sorensen A, et al. Correlation of reception binding and metabolic and mitogenic potencies of insulin analogs designed for clinical use [J]. Diabetes, 2000, 49(6): 999-1005.
[9]
Hod M, Mathiesen ER, Jovanovič L, et al. A randomized trial comparing perinatal outcomes using insulin detemir or neutral protamine Hagedorn in type 1 diabetes [J]. J Matern Fetal Neonatal Med, 2014, 27(1): 7-13.
[10]
Lambert K, Holt RI. The use of insulin analogues in pregnancy [J]. Diabetes Obes Metab, 2013, 15(10): 888-900.
[11]
Yamashita H, Shao J, Friedman JE. Physiologic and molecular alterations in carbohydrate metabolism during pregnancy and gestational diabetes mellitus [J]. Clin Obstet Gynecol, 2000, 43(1): 87-89.
[12]
Picard F, Wanatabe M, Schoonjans K, et al. Progesterone receptor knockout mice have an improved glucose homeostasis secondary to beta-cell proliferation [J]. Proc Natl Acad Sci USA, 2002, 99(24): 15644-15648.
[13]
吴静,薛耀明,李晨钟,等. 利用动态血糖监测系统观察妊娠糖尿病患者与中晚期的血糖漂移 [J].中国糖尿病杂志,2010,18(6): 449-451.
[14]
Ram M, Feinmesser L, Shinar S, et al. The importance of declining insulin requirements during pregnancy in patients with pre-gestational gestational diabetes mellitus [J]. Eur J Obstet Gynecol Reprod Biol, 2017, 215: 148-152.
[15]
Padmanabhan S, Lee VW, Mclean M, et al. The Association of Falling Insulin Requirements With Maternal Biomarkers and Placental Dysfunction: A Prospective Study of Women With Preexisting Diabetes in Pregnancy [J]. Diabetes Care, 2017, 40(10): 1323-1330.
[16]
American Diabetes Association. Management of diabetes in pregnancy: standards of medical care in diabetes-2020 [J]. Diabetes Care, 2020, 43(suppl 1): s183-s192
[17]
吴红花,妊娠期高血糖人群的胰岛素应用 [J]. 中华全科医师杂志, 2019, 18(1):14-17.
[18]
中华医学会妇产科学分会产科学组,中华医学会围产医学分会妊娠合并糖尿病协作组.妊娠合并糖尿病诊治指南(2014) [J].中华妇产科杂志, 2014, 49(8): 561-569
[19]
ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus [J]. Obstet Gynecol, 2018, 131(2): e49-e64.
[20]
Victoria L, Rudland, Sarah AL, et al. ADIPS 2020 guideline for pre-existing diabetes and pregnancy [J]. Aust N Z J Obstet Gynaecol, 2020, 60(6): E18-E52.
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