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Clinical characteristics and outcome of pregnancy in women with gestational hyperglycaemia with and without antibodies to β‐cell antigens
Author(s) -
Bo S.,
Menato G.,
Pinach S.,
Signorile A.,
Bardelli C.,
Lezo A.,
Marchisio B.,
Gentile L.,
Cassader M.,
Massobrio M.,
Pagano G.
Publication year - 2003
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2003.00721.x
Subject(s) - medicine , autoantibody , gestational diabetes , impaired glucose tolerance , diabetes mellitus , endocrinology , insulin resistance , body mass index , insulin , pregnancy , odds ratio , type 2 diabetes , gestation , antibody , immunology , biology , genetics
Aims To evaluate the prevalence of β‐cell autoantibodies in women with gestational diabetes and impaired glucose tolerance, and identify clinical characteristics differentiating hyperglycaemic patients with and without autoantibodies. Methods One hundred and twenty‐three pregnant patients with gestational diabetes, 84 with impaired glucose tolerance and 290 with normoglycaemia were evaluated for anti‐islet cell antibodies, glutamic acid decarboxylase (GAD) autoantibodies, and the components of the metabolic syndrome. Results Autoantibody positivity was 8.9%, 17.9% and 0.3% in patients with diabetes, impaired tolerance and normoglycaemia, respectively. Hyperglycaemic patients with autoantibodies had lower body mass index, waist, weight gain at the time of the screening test and a lower percentage of previous pregnancies than those without autoantibodies. In addition, their fasting insulin values were significantly lower and inversely related to the presence of autoantibodies (odds ratio (OR) = 0.64; 95% confidence interval (CI) 0.42–0.96), the lowest values being found in anti‐GAD + patients. Autoantibody‐positive women with diabetes were more frequently treated with insulin than negative patients (OR = 7.21; 95% CI 1.85–28.08). Conclusions Autoantibody‐positive women with gestational hyperglycaemia displayed fewer features of insulin resistance and required more frequent insulin therapy than negative women and presumably had presymptomatic Type 1 diabetes. If this conclusion is corroborated by the follow‐up of larger series, clinical and immunological distinction of types of gestational hyperglycaemia would be useful.