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| Effect of Insulin Based on Survival Analysis on Perioperative Gestational Diabetes Mellitus |
| CUI Jian, SHAO Liping, SHA Jing |
| Department of Obstetrics and Gynecology, Hospital of Xinjiang Production and Construction Corps, Urumqi 830002, China |
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Abstract Objective To evaluate the role of intermittent subcutaneous insulin injection, continuous subcutaneous injection, and insulin pumps in the treatment of perioperative gestational diabetes mellitus (GDM) in order to ensure effective and safe use of insulin. Methods A total of 120 GDM patients undergoing cesarean section between May 2012 and January 2015 were randomly selected as subjects. According to use methods of insulin, 35 cases were regarded as group A (subcutaneous injection), 42 cases as group B (pure continuous insulin pump injection), 43 as group C (continuous subcutaneous injection combined with the insulin pump). Survival analysis was used to study the effect of the three methods of insulin injection on blood glucose, insulin dosage, operation time, blood loss, low blood glucose reaction, incision healing, hospital stay, and neonatal adverse outcomes. Results The results showed that continuous subcutaneous injection combined with an insulin pump decreased blood glucose levels, insulin dosage, incidence of hypoglycemia and length of hospital stay , these indexes were all lower than those of group A and group B, and that incision healing was better than that of group A and B(P<0.05). There was no statistically significant difference in the neonatal adverse outcome, operation time and surgical blood loss between the three groups (P>0.05). Survival analysis showed that the fasting blood glucose was better controlled in group C and group B than in group A, and that blood glucose after a meal, insulin dosage, and hospital stay in group C were lower or shorter than in group A and group B. Conclusion The combination of continuous insulin pumps with subcutaneous injection is a more effective treatment of perioperative GDM than theinsulin pump alone or subcutaneous injection of insulin, for it can reduce the dosage of insulin and blood glucose reactions.
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Published: 02 November 2016
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2016, Vol. 34 
