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Presence of GAD-antibodies during gestational diabetes predicts type 1 diabetes

¹Department of Endocrinology and Diabetology, Lund University Hospital, Lund, Sweden
²Department of Endocrinology and Diabetology, Lund University Hospital, Lund, Sweden
³Department of Clinical Science, Lund University Hospital, Lund, Sweden
⁴Department of Obstetrics and Gynaecology, Lund University Hospital, Lund, Sweden
⁵Department of Endocrinology and Diabetology, Lund University Hospital, Lund, Sweden

Mona.Landin-Olsson{at}med.lu.se

ABSTRACT

OBJECTIVE: To study the frequency of have beta-cell specific autoantibody markers in women with gestational diabetes mellitus (GDM) and to follow these women to estimate the risk of later development of type 1 diabetes.

RESEARCH DESIGN AND METHODS: Out of 385 pregnant women with GDM during 1995 to 2005 in the district of Lund, 24 women (6%) were found positive for at least one of islet cell antibodies (ICA), glutamic acid decarboxylase antibodies (GADA) or tyrosine phosphatase antibodies (IA-2A). These women were followed and autoantibodies were reanalyzed and those who had not developed diabetes did an oral glucose tolerance test (OGTT). Known risk factors for both GDM and type 1 diabetes were compared to women who had GDM but without pancreatic autoantibodies.

RESULTS: Among the autoantibody positive women 50% had developed type 1 diabetes compared to none among the GDM controls (p=0.001), 21% had impaired fasten glucose (IFG) or impaired glucose tolerance (IGT) compared to 12,5% (p=0.3) and none had developed type 2 diabetes compared to 12.5% among controls (p=0.1).

CONCLUSIONS: Autoantibody screening in pregnant women with GDM should be considered for early recognition of type 1 diabetes and subsequent follow up after delivery.

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