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e-ECE: Autoantibodies in Pregnancy Tied to Adult-Onset T1DM

Detection of ICA, GADA, IA2A autoantibodies in women with gestational diabetes linked to decreased T1DM-free survival time, time to diagnosis

a pregnant woman

THURSDAY, June 3, 2021 (HealthDay News) -- Development of type 1 diabetes mellitus (T1DM) can be predicted by the presence of islet cell (ICAs) and glutamic acid decarboxylase (GADAs) autoantibodies in early pregnancy, according to a study presented May 24 at the 23rd European Congress of Endocrinology.

Kaisu Luiro, Ph.D., from Helsinki University Hospital in Finland, and colleagues conducted a prospective cohort study involving 391 women with gestational diabetes (GDM) and 391 matched controls who delivered in 1984 to 1994. First-trimester samples were analyzed for four autoantibodies associated with T1DM: ICAs, GADAs, insulin (IAAs), and insulinoma-associated antigen 2 autoantibodies (IA2As).

The researchers found that single autoantibody positivity was detected in 12 percent and 2.3 percent of the GDM and control cohorts, respectively. In the GDM cohort, 2.6 and 2.3 percent tested positive for two and three autoantibodies compared with one individual with two autoantibodies in the control cohort. In the GDM cohort, 12.5, 6.0, 4.9, and 1.2 percent had ICA, GADA, IA2A, and IAA positivity, while in the control cohort, 1.4, 0.8, 0.6, and 0.3 percent had GADA, IA2A, IAA, and ICA positivity, respectively. Decreased T1DM-free survival time and time to diagnosis were seen in association with detection of ICA, GADA, and/or IA2A autoantibodies. Individuals with three positive autoantibodies developed T1DM within seven years of GDM pregnancy. T2DM development occurred independently of autoantibody positivity.

"We also hope that health care professionals initiate conversations with their patients about the relationship between GDM and diabetes later in life," Luiro said in a statement.

Abstract

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