title: IgG4 subclass glutamic acid decarboxylase antibodies (GADA) are associated with a reduced risk of developing type 1 diabetes as well as increased C-peptide levels in GADA positive gestational diabetes.
abstract: Some women with gestational diabetes (GDM) present with autoantibodies associated with type 1 diabetes. These are usually directed against glutamic acid decarboxylase (GADA) and suggested to predict development of type 1 diabetes. The primary aim of this study was to investigate if GADA IgG subclasses at onset of GDM could assist in predicting postpartum development. Of 1225 women diagnosed with first-time GDM only 51 were GADA-positive. Total GADA was determined using ELISA. GADA subclasses were determined with radioimmunoassay. Approximately 25% of GADA-positive women developed type 1 diabetes postpartum. Titers of total GADA were higher in women that developed type 1 diabetes (142.1 vs 74.2u/mL; p=0.04) and they also had lower titers of GADA IgG4 (index=0.01 vs 0.04; p=0.03). In conclusion we found that that women with high titers of total GADA but low titers of GADA IgG4 were more prone to develop type 1 diabetes postpartum.
authors.affiliation: Lund University, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden. Electronic address: Jonatan.Dereke@med.lu.se.
authors.forename: Jonatan
authors.initials: J
authors.lastname: Dereke
authors.affiliation: Lund University, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden; Helsingborg Hospital, Department of Pediatrics, Helsingborg, Sweden. Electronic address: Charlotta.Nilsson@med.lu.se.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Nilsson
authors.affiliation: Skåne University Hospital Lund, Department of Obstetrics, Lund, Sweden. Electronic address: Helena.Strevens@med.lu.se.
authors.forename: Helena
authors.initials: H
authors.lastname: Strevens
authors.affiliation: Lund University, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden; Skåne University Hospital Lund, Department of Endocrinology, Lund, Sweden. Electronic address: Mona.Landin-Olsson@med.lu.se.
authors.forename: Mona
authors.initials: M
authors.lastname: Landin-Olsson
authors.affiliation: Lund University, Department of Clinical Sciences, Diabetes Research Laboratory, Lund, Sweden. Electronic address: Magnus.hillman@med.lu.se.
authors.forename: Magnus
authors.initials: M
authors.lastname: Hillman
mesh_terms: D000328:Adult; D002096:C-Peptide / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000503:physiopathology*; D016640:Diabetes, Gestational / Q000235:genetics / Q000276:immunology / Q000503:physiopathology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D002096:C-Peptide; D007074:Immunoglobulin G; D005968:Glutamate Decarboxylase
keywords: Gestational diabetes mellitus; Glutamic acid decarboxylase antibodies; IgG subclasses; Type 1 diabetes