Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2023; 14(10): 1532-1540
Published online Oct 15, 2023. doi: 10.4239/wjd.v14.i10.1532
Effects of insulin aspart and metformin on gestational diabetes mellitus and inflammatory markers
Yan Wang, Min Song, Bang-Ruo Qi
Yan Wang, Min Song, Bang-Ruo Qi, Department of Obstetrics and Gynecology, Sanya Women and Children’s Hospital Managed by Shanghai Children’s Medical Center, Sanya 572099, Hainan Province, China
Author contributions: Wang Y and Song M contributed equally to this study. Wang Y designed the research; Song M performed the research; Wang Y and Qi BR analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by Sanya Women and Children’s Hospital Managed by Shanghai Children’s Medical Center.
Informed consent statement: All patients have signed informed consent forms.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: According to the institutional policy, data for this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bang-Ruo Qi, MD, Lecturer, Department of Obstetrics and Gynecology, Sanya Women and Children’s Hospital Managed by Shanghai Children’s Medical Center, No. 339 Yingbin Road, Jiyang District, Sanya 572099, Hainan Province, China. bangruoqi@126.com
Received: July 6, 2023
Peer-review started: July 6, 2023
First decision: July 27, 2023
Revised: August 2, 2023
Accepted: August 15, 2023
Article in press: August 15, 2023
Published online: October 15, 2023
Abstract
BACKGROUND

Gestational diabetes mellitus (GDM) refers to hyperglycemia caused by insulin resistance or insufficient insulin secretion during pregnancy. Patients with GDM have a high risk of pregnancy complications, which can adversely affect both maternal and fetal health. Therefore, early diagnosis, treatment and monitoring of GDM are essential. In recent years, a new treatment scheme represented by insulin aspart combined with metformin has received increasing attention.

AIM

To explore the effects of insulin aspart combined with metformin on patients with GDM and inflammatory markers.

METHODS

From April 2020 to September 2022, 124 patients with GDM in Sanya Women and Children’s Hospital Managed by Shanghai Children’s Medical Center were collected and analyzed retrospectively. The control group (CG) comprised 62 patients treated with insulin aspart alone, and 62 patients treated with insulin aspart and metformin formed the observation group (OG). Before and after treatment, improvement of blood-glucose-related indexes [fasting blood glucose (FBG), 2-h postprandial glucose (2h PG) and hemoglobin A1c (HbA1c)], serum related factor [serum homocysteine (Hcy)], serum inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-6 and C-reactive protein (CRP)] were compared between the two groups. The clinical efficacy, adverse pregnancy outcomes and incidence of pregnancy complications were compared between the two groups.

RESULTS

After treatment, the levels of FBG, 2h PG, HbA1c, Hcy, TNF-α, IL-6 and CRP in both groups were significantly decreased (P < 0.05), and the levels of FBG, 2h PG, HbA1c, Hcy, TNF-α, IL-6 and CRP in the OG were lower than in the CG (P < 0.05). The total clinical effectiveness in the OG was higher than that in the CG (P < 0.05). The total incidence of adverse pregnancy outcomes and complications in the OG was significantly lower than in the CG (P < 0.05).

CONCLUSION

Insulin aspart combined with metformin are effective for treatment of GDM, which can reduce blood-glucose-related indexes, Hcy and serum inflammatory cytokines, and risk of adverse pregnancy outcomes and complications.

Keywords: Insulin aspart, Metformin, Gestational diabetes mellitus, Efficacy, Homocysteine, Tumor necrosis factor-α, Interleukin-6, C-reactive protein

Core Tip: This study investigated the clinical effect of insulin aspart combined with metformin on gestational diabetes mellitus and serum homocysteine (Hcy), tumor necrosis factor-α, interleukin-6 and C-reactive protein, which represents a novel aspect in the field. The combination of drugs significantly improved the condition of patients, reduced adverse pregnancy outcomes and incidence of adverse reactions, decreased blood-glucose-related indicators, Hcy, and serum inflammatory cytokine levels, and exhibited a high level of safety. These findings provide an important basis for the clinical application and popularization of this combination therapy.