Exercise-Diet Therapy Combined with Insulin Aspart Injection for the Treatment of Gestational Diabetes Mellitus: A Study on Clinical Effect and Its Impact.

Objective: To explore the clinical effect and impact of exercise-diet therapy combined with Insulin Aspart Injection on gestational diabetes mellitus (GDM). Methods: The objects of study were patients with pregestational diabetes mellitus (PGDM) and 62 patients with GDM who were diagnosed by oral glucose tolerance test (OGTT) and insulin release test from February 2017 to February 2019. According to the severity of the disease, enrolled patients were informed to have appropriate exercise and diet control or Insulin Aspart Injection on this basis until the completion of delivery. By using 50 pregnant women with normal glucose as the control, the fasting plasma glucose (FPG), 1-hour postprandial glucose (1hPG), 2-hour postprandial glucose (2hPG), nocturnal glucose, and glycosylated hemoglobin (HbA1c) levels were compared between the PGDM group and the GDM group before and after treatment; besides, further comparison was made in terms of glucose compliance rate, islet B-cell secretory function, and insulin resistance after treatment. The pregnant women were examined by B-ultrasound at 24 and 26 weeks of gestation to check if the fetus had abnormalities in the central nervous system and the heart. Further B-ultrasound examination was performed at 32 and 37 weeks of gestation to check the problems such as polyhydramnios and stillbirth. In addition, a comparative analysis was carried out in terms of the adverse pregnancy outcomes and complications, associated with the comparison of the results after treatment with control group. Results: After treatment, the levels of FPG, 1hPG, 2hPG, nocturnal glucose, and HbA1c were decreased in the PGDM group and GDM group than those before treatment, especially in the GDM group, with significant difference still when compared with the control group (P < 0.05). Statistical analysis revealed that the blood glucose compliance rate in the GDM group was higher than that in the PGDM group, showing a better therapeutic effect. Fasting insulin (FINS) and homeostasis model assessment index for insulin resistance (HOMA-IR) in the GDM group were significantly higher than those in control group, but lower than those in the PGDM group (P < 0.01), while the level of HOMA-ß was lower in the GDM group than that in the control group and higher than that in PGDM (P < 0.01). Further ultrasound examination revealed the presence of fetal cardiac abnormality, polyhydramnios, stillbirth, and problems, showing a higher incidence in the PGDM group but almost nonexistence in the control group. In addition, the incidence of hypertension, macrosomia, premature rupture of membranes, postpartum hemorrhage, and infection were obviously higher in the PGDM group than those in the GDM group and control group (P < 0.05). Conclusion: Exercise-diet therapy combined with Insulin Aspart Injection can effectively control the blood glucose level of pregnant patients with GDM, improve the pregnancy outcome to a certain extent, and ensure the health of pregnant women and fetus, which is worthy of clinical application.

Clinical efficacy and safety of the Jinfeng pill in the adjuvant treatment of infertility in patients with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trial.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disease leading to infertility in women of childbearing age. Adjuvant therapy with Jinfeng pills (a traditional Chinese medicine) can increase ovarian blood flow, regulate female endocrine levels, and achieve good therapeutic effect. A systematic review and meta-analysis were conducted to examine the efficacy and safety of Jinfeng pills. METHODS: The PubMed (2000 to August 2021), Excerpta Medica Database (2000 to August 2021), Chinese Biomedical Literature (2000 to August 2021), and China National Knowledge Infrastructure (2000 to August 2021) databases were searched. All patients with PCOS were included in the randomized controlled study of Jinfeng pills combined with an adjuvant Western medicine treatment. After screening and a risk of bias assessment, Stata16.0 software was used for the analysis. RESULTS: A total 7 of articles (comprising 691 patients; 26-83 participants per group) were included in the meta-analysis. The meta-analysis showed that the effective rate the experimental group treated with Jinfeng pills combined with adjuvant Western medicine was higher than that of the control group treated with Western medicine only [relative risk (RR) =1.15, 95% confidence interval (CI): 1.03 to 1.28; P=0.015]. After treatment, the follicle-stimulating hormone level of the experimental group was significantly lower than that of the control group [mean difference (MD) =-5.10, 95% CI: -7.95 to -2.24; P=0.0005], the estradiol level of the experimental group was significantly higher than that of the control group (MD =10.74, 95% CI: 4.19 to 17.29; P=0.001), the testosterone level of the experimental group was significantly lower than that of the control group (MD =-1.17, 95% CI: -2.09 to -0.25; P=0.01), and the pregnancy rate of the experimental group was significantly higher than that of the control group (RR =1.36, 95% CI: 1.13 to 1.64; Z=3.183; P=0.001). DISCUSSION: The therapeutic effect of Jinfeng pills combined with Western medicine in treating PCOS was better than that of Western medicine alone, and there was no increase in adverse reactions.