Presence of GAD Antibodies During Gestational Diabetes Mellitus Predicts Type 1 Diabetes

  1. Charlotta Nilsson, MD1,
  2. Dag Ursing, MD1,
  3. Carina Törn, BSC, PHD2,
  4. Anders Åberg, MD, PHD3 and
  5. Mona Landin-Olsson, MD, PHD1
  1. 1Department of Endocrinology and Diabetology, Lund University Hospital, Lund, Sweden
  2. 2Department of Clinical Science, Lund University Hospital, Lund, Sweden
  3. 3Department of Obstetrics and Gynaecology, Lund University Hospital, Lund, Sweden
  1. Address correspondence and reprint requests to Mona Landin-Olsson, Department of Endocrinology and Diabetology, Lund University Hospital, S- 221 85 Lund, Sweden. E-mail: mona.landin-olsson{at}med.lu.se

Abstract

OBJECTIVE—We sought to study the frequency of β-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—Of 385 pregnant women with GDM during 1995–2005 in the district of Lund, 24 (6%) women were found positive for at least one of the following: islet cell antibody (ICA), GAD antibody (GADA), or tyrosine phosphatase antibody (IA-2A). The women were followed and autoantibodies reanalyzed. Those who had not developed diabetes did an oral glucose tolerance test. The frequencies of known risk factors for GDM were compared in women with GDM with and without pancreatic autoantibodies.

RESULTS—Among the autoantibody-positive women, 50% had developed type 1 diabetes compared with none among the GDM control subjects (P = 0.001), 21% had impaired fasting glucose or impaired glucose tolerance compared with 12.5% among control subjects (P = 0.3), and none had developed type 2 diabetes compared with 12.5% among control subjects (P = 0.1).

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

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 22 May 2007. DOI: 10.2337/dc07-0157.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted May 13, 2007.
    • Received January 25, 2007.
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  1. Published online before print May 22, 2007, doi: 10.2337/dc07-0157 Diabetes Care August 2007 vol. 30 no. 8 1968-1971
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