부산대학교 도서관

Post natal hypoglycemia related to hyperinsulinism of diabetic women fetuses is presently the major complication of IDM. The aim of this study was to determine hyperinsulinism degree to lead to an appropriate metabolic management. Circulating immunoreactive C peptide provides a means of studying B cell function of IDM because insulin-antibudies cross the placenta; but its RIA requires some delay and so is not usefull in practice. So, other criteria were successively investigated, and were compared to blood C peptide nmol/l / glucose mmol/l ratio (0.12 ± 0.01 sem in control group). No significant correlation with maternal HbA1c % determined on prenatal period is found. There is no significant difference in serum glucosamine levels between IDM and controls. A statistical correlation (rs0.62 p < 0.05) with macrosomia index is found for an index > 1.2. It appeared a negative correlation (r 0.56 p < 0.001 n 35) with serum levels of branch chain aminoacicis which is thought to be an indirect index of hyperinsulinism; results were obtained in relative short time (24 h) : hyperinsulinism is found to a sum level< 200 mcmol/l. There is a close correlation with serum insulin determined by classical or recent quick RIA (r 0.08 p< 0.001 n 33). Results can be obtained within very short time (4 hours). So, actually, 3 repeated routine quick insulin RIA compared to relative blood glucose, offer a direct and rapid way to evaluate IDM hyperinsulinism and hypoglyeeomi c risk, rnak ing possible an appropriate management.