Islet Cell Antibodies and Beta‐cell Function in Gestational Diabetic Women: Comparison to First‐degree Relatives of Type 1 (Insulin‐dependent) Diabetic Subjects

Abstract

In order to further characterize women with islet cell antibodies (ICA) at the diagnosis of gestational diabetes (GDM), we aimed to compare titres and persistence as well as B-cell function with those of ICA+ first-degree relatives of Type 1 (insulin-dependent) diabetic subjects. Titres at detection of ICA were compared between 69 women with GDM and 53 relatives. Persistence of ICA positivity was investigated in 33 ICA+ gestational diabetic women and 39 relatives (mean follow-up: 13 months). Assessment of the acute insulin response, through an intravenous glucose tolerance test (IVGTT), was carried out in 9 ICA+ women with previous GDM and normal oral glucose tolerance, and their results were compared to those of a control group (9 women) and a group of 12 adult ICA+ relatives. In comparison with first-degree relatives, women with GDM had a higher ICA prevalence, especially with titres of < 20 JDF, and a similar persistence at follow-up. Women with ICA at diagnosis of GDM and normal oral glucose tolerance after pregnancy showed a decreased insulin response to glucose as compared to the control group. Results of the IVGTT closely paralleled those from adult ICA+ relatives. It is concluded that ICA+ gestational diabetic women share with ICA+ first-degree relatives of Type 1 diabetic subjects metabolic and immunologic disturbances.