Effects of metformin combined with insulin aspart on gestational weight gain, lipid metabolism, immune function, and delivery outcomes in pregnant women with gestational diabetes

Abstract

Objective: To evaluate the effects of metformin combined with insulin aspart on gestational weight gain, lipid metabolism, immune function, and delivery outcomes in women with gestational diabetes mellitus (GDM).

Methods: Clinical data from 95 GDM patients were retrospectively analyzed. Patients were divided into two groups: the control group (45 cases) received only insulin aspart, and the study group (50 cases) received a combination of metformin and insulin aspart. Clinical efficacy, blood glucose levels, body weight, lipid metabolism levels [total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low - density lipoprotein cholesterol (LDL-C)], immune function, insulin resistance [fasting insulin (FINS), homeostasis model assessment of β-cell function (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR)], inflammatory markers, delivery outcomes, and drug safety were compared between the two groups.

Results: The study group had a significantly higher total effective rate (96.00%) compared to the control group (80.00%) (P < 0.05). Post-treatment, blood glucose levels decreased significantly in both groups, with lower levels observed in the study group (all P < 0.05). Both groups showed weight gain, but the increase was less in the study group (P < 0.05). Levels of TC, TG, LDL-C, FINS, HOMA-IR, and inflammatory markers decreased significantly in both groups, with greater reductions in the study group (all P < 0.05). HDL-C, immune function markers, and HOMA-β increased, with more significant increases in the study group (all P < 0.05). The incidence of adverse delivery outcomes was significantly lower in the study group (26.00% vs. 62.22%) (P < 0.05), with no significant difference in adverse reaction rates (10.00% vs. 8.89%) (P > 0.05).

Conclusion: Metformin combined with insulin aspart demonstrates significant therapeutic benefits in treating GDM. It effectively regulates blood glucose and lipid metabolism, controls weight gain, enhances immune function, reduces insulin resistance, suppresses inflammation, and lowers the incidence of adverse delivery outcomes, with good drug safety.

Keywords: Gestational diabetes mellitus; delivery outcomes; immune function; insulin aspart; lipid metabolism; metformin; weight.

Figure 1

Comparison of blood glucose indicators and body weight between the two groups. A: FPG; B: HbA1c; C: 2 hPG; D: Body weight. Note: Compared with the group Pre-tx, ***P < 0.01; Compared with the control group, ###P < 0.01. FPG, fasting plasma glucose; HbA1c, glycated hemoglobin; 2 hPG, 2-hour post-meal plasma glucose; Pre-tx, pre-treatment.

Figure 2

Comparison of lipid metabolism -related indexes between the two groups. A: TC; B: TG; C: LDL-C; D: HDL-C. Note: Compared with the group Pre-tx, ***P < 0.01; Compared with the control group, ###P < 0.01. TC, total cholesterol; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; Pre-tx, pre-treatment.

Figure 3

Comparison of insulin resistance-related indexes between the two groups. A: FINS; B: HOMA-β; C: HOMA-IR. Note: Compared with the group Pre-tx, ***P < 0.01; Compared with the control group, ###P < 0.01. FINS, fasting insulin; HOMA-β, homeostasis model assessment of β-cell function HOMA-IR, homeostasis model assessment of insulin resistance; Pre-tx, pre-treatment.

Figure 4

Comparison of insulin resistance-related indexes between the two groups. A: IL-1β; B: IL-8; C: TNF-α; D: CRP. Note: Compared with the group Pre-tx, ***P < 0.01; Compared with the control group, ###P < 0.01. IL-1β, interleukin-1β; IL-8, interleukin-8; TNF-α, tumor necrosis factor-α; CRP, C-reactive protein; Pre-tx, pre-treatment.