Prevalence and features of pancreatic islet cell autoimmunity in women with gestational diabetes from different ethnic groups

Objective To assess the prevalence and characteristics of islet cell autoim munity amongst women with gestational diabetes selected from South Asian an d Afro-Caribbean as well as European populations. Design Cross-sectional retrospective survey of subject cohort. Population Three hundred and twenty-one women with a recent history of gest ational diabetes (173 European, 86 South Asian and 62 Afro-Caribbean), a me dian (range) of 22 (1-150) months postpartum. Results Antibodies to Glutamic acid decarboxylase were found in 13 (4%) of these women. There was no difference in the prevalence of anti-glutamic aci d decarboxylase positivity between the three ethnic groups (European 4.6%, South Asian 3.5%, Afro-Caribbean 3.2%). Anti-glutamic acid decarboxylase po sitive women were leaner than anti-glutamic acid decarboxylase negative wom en (body mass index, median (upper-lower quartile) 23.9 (22.5-26.7) vs 26.6 (23.4-30.5)kg/m(2), P = 0.03, P = 0.049 allowing for ethnicity). There was no difference between glutamic acid decarboxylase-positive and glutamic ac id decarboxylase-negative women for age, family history of diabetes, waist/ hip ratio, prevalence of insulin treatment during pregnancy, postpartum glu cose status, lipid profile and indices of insulin action and beta-cell func tion. Conclusions Markers of islet cell autoimmunity are found as frequently in g estational diabetes women of South Asian and Afro-Caribbean origin, as they are in European subjects. Identification of future risk of type 1 diabetes is relevant to the planning of clinical management and intervention strate gies in women with gestational diabetes of all major ethnic groups.