Source: Gut  |  Posted 9 years ago

Autoantibody-positive women with gestational hyperglycaemia have fewer features of insulin resistance and need insulin more often than do autoantibody-negative women.

The autoantibody-positive women presumably have pre-symptomatic type 1 diabetes, say Italian researchers. They added that if that were corroborated by the follow-up of larger series, it would be useful to make clinical and immunological distinctions between types of gestational hyperglycaemia.

The researchers from the University of Turin and the Hospital of Asti, assessed the prevalence of beta-cell autoantibodies in women with gestational diabetes and impaired glucose tolerance. They also sought to identify clinical characteristics which differentiated hyperglycaemic patients with and without autoantibodies.

One hundred and twenty three patients with gestational diabetes, 84 patients with impaired glucose tolerance and 290 normoglycaemic patients were all assessed for anti-islet cell antibodies, glutamic acid decarboxylase autoantibodies and the components of the metabolic syndrome.

Autoantibody positivity was 8.9% in patients with diabetes, 17.9% in patients with impaired tolerance and 0.3% in patients with normoglycaemia.

Hyperglycaemic patients with autoantibodies had lower body mass index, smaller waist measurements, less weight gain at the time of the screening test and a lower percentage of previous pregnancies than hyperglycaemic patients who did not have autoantibodies.

Also, the fasting insulin values of hyperglycaemic patients were significantly lower. These values were inversely related to the presence of autoantibodies, with the lowest values in patients who were positive for anti-glutamic acid decarboxylase.

Autoantibody-positive women with diabetes were treated more often with insulin than those who were autoantibody-negative.