Treatment of diabetic patients when assisting in pregnancy

  1. Reduce glucose: pay attention to monitoring blood glucose and glycosylated hemoglobin level during pregnancy assistance, and keep blood glucose down to normal level and glycosylated hemoglobin less than 6%; 2. Prevent and correct infection: diabetic patients are prone to infection, especially genitourinary system infection. Pay attention to testing the patient’s blood routine, urine routine and white belt routine during pregnancy assistance to correct the infection in time. Pay attention to the aseptic operation of egg retrieval, endosculpture and other surgical operations, and apply antibiotics prophylactically when necessary; 3. Improve hyperandrogenemia: (1) Oral contraceptives: Da-Ying-35, the main component of cyproterone acetate, can compete with androgen receptors to exert anti-androgenic effects, and has progestin-like effects, which can inhibit the production of LH and androgens and increase the clearance of androgens by the liver. (2) Insulin sensitizers: metformin and pioglitazone. Both can reduce insulin resistance, improve blood glucose and lipid metabolism, inhibit androgen secretion in follicular membrane cells and adrenal glands, and at the same time promote the synthesis of sex hormone tuberculoglobulin, indirectly lowering androgen levels; 4. Ovulation promotion: Due to the different insulin levels and blood glucose control in DM patients, some patients may show signs of polycystic ovaries, and some patients may have decreased ovarian reserve and poor egg development. The appropriate ovulation promotion method needs to be chosen according to the patient’s specific situation when assisting pregnancy.