PREVALENCE AND PREDICTIVE VALUE OF ISLET-CELL ANTIBODIES AND INSULIN AUTOANTIBODIES IN WOMEN WITH GESTATIONAL DIABETES

The objective of the present study was to investigate the predictive v alue of islet cell antibodies (ICA) and insulin autoantibodies (IAA) f or development of diabetes in women with previous gestational diabetes (GDM). Two hundred and forty-one previous diet-treated GDM patients a nd 57 women without previous GDM were examined 2-11 years after the in dex pregnancy. In subgroups, plasma from the diagnostic OGTT during in dex pregnancy was analysed for ICA and IAA. Among the previous GDM pat ients, 3.7 % had developed Type 1 diabetes and 13.7 % Type 2 diabetes. Four (2.9 %) of the 139 GDM patients tested for ICA were ICA-positive and three of these had Type 1 diabetes at follow-up, as well as three ICA-negative patients. The sensitivity, specificity, and predictive v alue of ICA-positivity for later development of diabetes were 50 %, 99 %, and 75 %, respectively. None of the women was IAA-positive during pregnancy. In conclusion, the majority of the patients with GDM did no t show evidence of ongoing autoimmune destruction of the beta cells du ring the index pregnancy. However, ICA-positive GDM patients had a hig h risk of developing Type 1 diabetes later in life.