OBJECTIVE -Our aim was to evaluate the predictive value of gestational diabetes mellitus (GDM), diabetes-associated autoantibodies, and other factors for development of clinical diabetes later in life.RESEARCH DESIGN AND METHODS -In this case-control study the presence of autoantibodies was studied in 435 women with GDM and in healthy matched control subjects. The need for exogenous insulin during GDM was recorded. In the GDM group, the mean follow-up period was 5.7 years and in the control group 6.1 years.RESULTS -Among the subjects with GDM, 20 (4.6%) developed type 1 diabetes and 23 (5.3%) developed type 2 diabetes, whereas none of the control subjects became diabetic. Twothirds of those who developed type 1 diabetes tested positive initially for islet cell antibodies (ICAs), whereas 56% of them had autoantibodies to GAD (GADAs) and 38% to the protein tyrosine phosphatase-related IA-2 molecule. Only 2 of the 23 women who presented later with type 2 diabetes tested positive for autoantibodies. According to multivariate analysis, initial age Յ30 years, the need for insulin treatment for GDM, and antibody positivity for ICAs and GADAs were associated with increased risk for clinical type 1 diabetes.CONCLUSIONS -Pregnancy seems to identify women who are at risk of developing diabetes later in life. About 10% of Finnish women with GDM will develop diabetes over the next 6 years; nearly half of them develop type 1 diabetes and the other half type 2 diabetes. Age Յ30 years, the need for insulin treatment during pregnancy, and positivity for ICAs and GADAs confer a high risk of subsequent progression to type 1 diabetes in women affected by GDM. Diabetes Care 29:607-612, 2006N ormal pregnancy induces insulin resistance (1), which may unmask diabetes or reduced insulin secretory capacity. The incidence of gestational diabetes mellitus (GDM) has been reported to be 2-5% during pregnancy (1). The condition is associated with both impaired insulin action and secretion, defects that are also characteristic of type 2 diabetes (2). Women with GDM have a considerable risk of developing type 2 diabetes later in life, but the risk of developing type 1 diabetes is also increased (3-5).The presence of circulating autoantibodies to various islet cell proteins is one of the most thoroughly characterized immune phenomena associated with type 1 diabetes (6). These autoantibodies are the detectable markers of an ongoing destructive process in the islets and thus provide a potential tool to identify individuals at risk of developing the disease in the future. Diabetesassociated autoantibodies have a high positive predictive value (PPV) for clinical type 1 diabetes among relatives of affected patients. The results of recent studies have implied that the PPV of autoantibodies associated with type 1 diabetes is also high in women with GDM (7). Although the antibody status of women with GDM may vary, depending on the phase of pregnancy and treatment mode for GDM, as well as on the methods used for antibody detection, most investigators hav...

Objective To compare sonographic endometrial characteristics in in-vitro fertilization (IVF)

Objective To assess intraobserver and interobserver variability in ovarian volume and gray-scale and color flow index measurements using transvaginal, threedimensional, power Doppler ultrasonography. Methods VI, 0.70 and 0.81, respectively), but for FI measurements the reproducibility was poor (inter-CC = 0.29, r = 7.87). Conclusions