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目的研究生活方式干预对妊娠糖尿病(GDM)患者产后糖调节受损者(IGR)胰岛素抵抗、胰岛β细胞功能状态的影响。方法对2009年1-12月在宁波大学医学院附属医院及宁波妇女儿童医院产科分娩的GDM患者于产后6~8周行75 g口服葡萄糖耐量试验(OGTT),将筛选为糖耐量减低(IGT)或空腹血糖调节受损(IFG)的女性分为干预组(59例)和对照组(67例)。对干预组进行2年的生活方式干预和密切随访,对照组仅发放健康宣传资料,观察其体质指数(BMI)、胰岛素抵抗和胰岛β细胞功能的变化。结果与对照组比较,干预组BMI、稳态模型胰岛素抵抗指数(HOMA-IR)下降,差异均有统计学意义(P<0.05,P<0.01);胰岛β细胞功能指数和早期相胰岛素分泌指数升高,差异均有统计学意义(P<0.01)。结论对GDM产后葡萄糖调节受损者进行生活方式干预和积极随访可明显改善胰岛β细胞分泌功能及胰岛素抵抗,恢复早期分泌相,提高胰岛素敏感性。
Objective To investigate the effect of lifestyle intervention on insulin resistance and pancreatic β-cell function in post-partum glucose-impaired (IGR) patients with gestational diabetes mellitus (GDM). Methods 75 g oral glucose tolerance test (OGTT) was performed at 6-8 weeks after delivery in obstetric delivery of GDM patients from Ningbo University School of Medicine and Ningbo Women and Children Hospital from January 2009 to December 2009. ) Or impaired fasting glucose regulation (IFG) were divided into intervention group (n = 59) and control group (n = 67). Two-year lifestyle intervention and close follow-up were conducted in the intervention group. The control group only issued health promotion materials and observed the changes of body mass index (BMI), insulin resistance and pancreatic β-cell function. Results Compared with the control group, the BMI and HOMA-IR of the intervention group were significantly decreased (P <0.05, P <0.01); the islet β-cell function index and the early phase insulin secretion index Increased, the differences were statistically significant (P <0.01). Conclusion Life-style intervention and positive follow-up of impaired glucose regulation in postnatal GDM patients can significantly improve pancreatic β-cell secretion and insulin resistance, restore early secretory phase and improve insulin sensitivity.