Clinical characteristics and outcome of pregnancy in women with gestational hyperglycaemia with and without antibodies to β‐cell antigens

Abstract

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.

Adult-Onset Type 1 Diabetes and Pregnancy: Three Case Reports

“…In addition, it has been found out that women with GDM and autoantibodies more frequently need insulin therapy [4, 5]; however, it has to be underlined that these patients are younger than those included in our case reports.…”

“…Women with GDM are consequently believed to be at higher risk of developing type 2 diabetes after pregnancy. About 10% of GDM patients become pancreatic autoantibody positive, however, so—although type 1 diabetes generally develops in younger people (under 30 years old)—we need to bear in mind that older patients might conceivably develop an adult-onset type 1 diabetes during or after pregnancy [2–4]. …”

Gestational Diabetes: Seeing Both the Forest and the Trees

“…There is a paucity of data regarding the clinical characteristics and pregnancy outcomes of women with positive diabetes-related autoantibodies and GDM. Antibody positivity has been inconsistently associated with a normal prepregnancy BMI, lower weight gain during pregnancy, lower fasting insulin, human leukocyte antigen alleles DR3 and DR4, and insulin treatment during pregnancy [46][47][48]. Studies that have investigated obstetric and neonatal outcomes have conflicting results; one study reported no significant difference in pregnancy outcomes [48] and another reported an increase in stillbirth and macrosomia rates [47].…”

“…Antibody positivity has been inconsistently associated with a normal prepregnancy BMI, lower weight gain during pregnancy, lower fasting insulin, human leukocyte antigen alleles DR3 and DR4, and insulin treatment during pregnancy [46][47][48]. Studies that have investigated obstetric and neonatal outcomes have conflicting results; one study reported no significant difference in pregnancy outcomes [48] and another reported an increase in stillbirth and macrosomia rates [47]. However, the latter study included women with more severe hyperglycemia during pregnancy, i.e., women who were likely to have had first presentation of type 1 diabetes during pregnancy and women for whom commencement of appropriate insulin therapy was delayed, which is likely to have negatively biased the results.…”

Gestational Diabetes Mellitus After Delivery

“…In studies carried out on women with GDM that show positive antibodies, it was found that they were younger, showed lower body mass index (BMI), less proportion of family members with diabetes, less abdominal circumference, and lower levels of plasmatic insulin than in those women without antibodies. Moreover, they had gained less weight during pregnancy and had required insulin treatment in a higher proportion (Bo et al, 2003). Non-Caucasian women with GDM have been less studied looking for autoimmune markers, being found in some cases, similar GADA incidence than in Caucasian women (Kousta et al, 2001), while in other studies, lower incidences have been obtained, but resulting likewise, the presence of antibodies against beta cells, an indicator of future type 1 diabetes, even at early stages after delivery (Yu et al, 2009).…”