GAD65 AUTOANTIBODIES IN WOMEN WITH GESTATIONAL OR INSULIN-DEPENDENT DIABETES-MELLITUS DIAGNOSED DURING PREGNANCY

We have studied the presence of GAD65 autoantibodies in women with ins ulin-dependent diabetes mellitus (IDDM) (M = 28) or gestational diabet es (GDM) (n = 139) diagnosed during pregnancy and investigated the tem poral relationship between these autoantibodies and the subsequent rec urrence or development of IDDM, Among the GDM pa tients, 4.3 % (6 of 1 39) developed true IDDM during a median follow-up period of 6.3 years (range 4.0-11.0). Of these, 2.2 % (3 of 139) were positive for GAD65 a utoantibodies at diagnosis of GDM compared to 0% (0 of 27) of healthy pregnant women, All 3 GAD65 autoantibody positive GDM patients subsequ ently developed IDDM after a median of 14 months (range 4-34). GAD65 a utoantibodies were present in 50 % (14 of 28) of sera from women with IDDM diagnosed during pregnancy. The non-insulin-requiring remission p eriod was significantly shorter in GAD65 autoantibody positive patient s (median 0.5 years [range 0-6.0 years]) than in GAD65 antibody negati ve patients (median 2.6 years; range 0-9.7 years; p < 0.05). The resul ts suggest that screening for GAD65 autoantibodies in women with GDM o r IDDM diagnosed during pregnancy may be useful for predicting the cli nical course of the disease.