title: Postpartum development of type 1 diabetes in Asian Indian women with gestational diabetes.
abstract: OBJECTIVE
  To study the postpartum conversion of gestational diabetes mellitus (GDM) to different types of diabetes among Asian Indian women.
  
  
  METHODS
  Using data from electronic medical records, 418 women with GDM seen at a tertiary diabetes care center for diabetes in Chennai in South India between 1991 and 2014 were evaluated for development of diabetes postpartum.
  
  
  RESULTS
  Of the 418 GDM women followed up postpartum, 388 progressed to diabetes. Of these 359 (92.5%) developed type 2 diabetes (T2DM) and 29 women (7.5%) developed type 1 diabetes (T1DM). The median time to development of T1DM was 2 years (interquartile range 2 [IQR]) while for T2DM it was 5 years (IQR 6). Women who developed T1DM had significantly lower mean body mass index (BMI) (20.4 ± 2.8 vs. 27.5 ± 4.4 kg/m2,P= 0.001), and higher fasting plasma glucose (222 ± 105 vs. 165 ± 62 mg/dlP= 0.008) and glycated hemoglobin levels (10.2 ± 2.7 vs. 8.5 ± 2.1%P< 0.001) compared to those who developed T2DM. Glutamic acid decarboxylase (GAD) autoantibodies were present in 24/29 (82.7%) of women who developed T1DM.
  
  
  CONCLUSIONS
  A small but significant proportion of women with GDM progress to T1DM postpartum. Measurement of GAD antibodies in leaner women with more severe diabetes could help to identify women who are likely to develop T1DM and thus prevent their presentation with acute hyperglycemic emergencies after delivery.
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Unnikrishnan
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Coimbatore Subramanian
authors.initials: CS
authors.lastname: Shanthi Rani
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Subash Chandrabose
authors.initials: SC
authors.lastname: Uthra
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Jaydeep
authors.initials: J
authors.lastname: Vidya
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Ganesan Uma
authors.initials: GU
authors.lastname: Sankari
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Ulagamathesan
authors.initials: U
authors.lastname: Venkatesan
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Saravanan Jeba
authors.initials: SJ
authors.lastname: Rani
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
keywords: Asian Indians; South Asians; gestational diabetes mellitus; glutamic acid decarboxylase; postpartum; type 1 diabetes; type 2 diabetes