Incidence and significance of islet cell antibodies in women with previous gestational diabetes.
Islet cell antibodies (ICAs) are markers for patients at risk for insulin-dependent diabetes and are associated with progressive beta-cell destruction. This prospective study was performed to estimate the incidence of these antibodies in 187 women with previous gestational diabetes. With a specific protein A monoclonal antibody (MoAb) assay, the incidence of ICAs was only 1.6% (3 of 187). Oral and intravenous glucose tolerance tests were performed in these 3 women and compared with 6 women with previous gestational diabetes without ICAs and 5 control women. Glucose tolerance was impaired only in the 3 women with ICAs, who also had an increase (P less than 0.03) in fasting plasma glucose and a decrease (P less than 0.03) in early first-phase insulin response. We conclude that the more specific MoAb method indicates a lower incidence of ICA in women with a history of gestational diabetes than previously reported and that a decreased first-phase insulin response is associated with the presence of ICAs, suggesting progressive islet cell damage.
Department of Obstetrics and Gynecology, University of Vermont College of Medicine, Burlington.
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Catalano
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Tyzbir
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Sims
D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis*; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007515:Islets of Langerhans / Q000276:immunology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000276:immunology*
D001323:Autoantibodies; D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; C024211:islet cell antibody