| Project/Area Number |
11671591
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Obstetrics and gynecology
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| Research Institution | Hokkaido University |
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Principal Investigator |
YAMADA Hideto Hokkado Univ., Grad. School of Medicine, Obstetrics and Gynecology, Lecturer, 医学部・附属病院, 講師 (40220397)
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| Co-Investigator(Kenkyū-buntansha) |
HIRAYAMA Emi Hokkaido Univ., Grad. School of Medicine, Obstetrics and Gynecology, 医学部・附属病院, 医員
岸田 達朗 北海道大学, 医学部・附属病院, 助手 (60260395)
和田 真一郎 北海道大学, 医学部・附属病院, 助手 (30301906)
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| Project Period (FY) |
1999 – 2001
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| Project Status |
Completed (Fiscal Year 2001)
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| Budget Amount *help |
¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 2001: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2000: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 1999: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | Gestational Diabetes / Insulin |
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| Research Abstract |
The aim of this study was to evaluate the insulin dynamics of patients with gestational diabetes mellitus (GDM) and to compare perinatal outcomes according to the insulin response patterns. Twenty-two of consecutive 925 women examined were diagnosed as having GDM. One hundred ten women who experienced normal pregnancy were used as controls. Plasma glucose levels and insulin responses were evaluated by 2-hours 75 g OGTT. Immunoreactive insulin (IRI), area under the curves (AUC) of glucose (AUCg), AUC of insulin (AUCi), and insulinogenic index (II=ΔIRI 30'/ΔBS30') were measured. The GDM patients were divided into three subgroups, consisting of a hyper-, normo-, and hypoinsulinemia group, according to the mean ± 2SD of AUCi obtained from the controls. Clinical and laboratory findings were compared among the GDM subgroups and controls. The GDM patients showed impaired insulin secretion to glucose stimuli, with low plasma insulin levels (30') and reduced insulin/glucose ratios (30' and 60') early in 75 g OGTT. The II and AUCi/AUCg values of GDM patients were reduced as compared with those of controls. These reduced insulin responses were remarkable in hypo- and normoinsulinemic GDM patients, but were not detected in hyperinsulinemic GDM patients. The rate of large for gestational age baby in normo- and hypoinsulinemic GDM patients was significantly higher than that of hyperinsulinemic GDM patients or controls. Hyperinsulinemic GDM patients had a high frequency of pregnancy induced hypertension (40 %). Body mass index prior to pregnancy of hyperinsulinemic GDM Patients was significantly higher than that of normoinsulinemic GDM patients or controls. It was demonstrated that not only insulin secretion but also perinatal clinical characteristics differed among the GDM subgroups. The heterogeneity of the disease was thus confirmed.
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