Diabetes Care, Vol 20, Issue 1 81-83, Copyright © 1997 by American Diabetes Association
Low prevalence of islet autoantibodies in patients with gestational diabetes mellitus
N Dozio, A Beretta, C Belloni, M Castiglioni, S Rosa, E Bosi and E Bonifacio
Department of Medicine, H. San Raffaele Scientific Institute, University of Milano, Italy. dozion@imihsra.it
OBJECTIVE: To determine the proportion of patients with gestational
diabetes mellitus (GDM) who have serological characteristics typical of
IDDM. RESEARCH DESIGN AND METHODS: Islet cell antibodies (ICAs), insulin
autoantibodies (IAAs), GAD65, and IA-2 antibodies were measured in 145
pregnant women with GDM, 33 with impaired glucose tolerance (IGT), and in
73 with normal glucose tolerance (NGT). ICAs were measured by indirect
immunofluorescence; GAD65 and IA-2 antibodies, by a radio-ligand
immunoassay incorporating 35S-labeled recombinant antigen; and IAAs, by a
liquid-phase radiobinding assay. RESULTS: The prevalences of islet
autoantibodies were low and not significantly different between groups.
ICAs were detected at levels ranging from 5 to 45 Juvenile Diabetes
Foundation U in 14 (10%) women with GDM, 2 (6%) women with (GT, and in 4
(5%) women with NGT. IAAs were detected at levels between 3 and 4 SD above
the mean in 4 (3%) women with GDM, 0 women with IGT, and in 1 (1%) woman
with NGT. None had both ICAs and IAAs. Neither GAD65 nor IA-2 antibodies,
which have been detected in the majority of pre-IDDM and IDDM patients,
were found in NGT, IGT, or GDM patients. CONCLUSIONS: Low-titer ICAs and
IAAs are not infrequent in pregnant women, but multiple islet
autoantibodies and antibodies to GAD65 or IA-2 were not found in GDM. These
findings suggest that the serological characteristics of IDDM are rare in
GDM.