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A retrospective analysis
Autoantibodies to GAD (GADa) have been the source of considerable attention because of their association with the development of type 1 diabetes. As a consequence, several groups have been interested in the relationship between GADa in women with gestational diabetes and the subsequent occurrence of permanent diabetes. Interestingly, publications on this subject, emanating primarily from Europe, have been notable for their lack of unanimity concerning the rates of autoantibody positivity. These rates have ranged from 0% GADa positivity in gestational diabetic women from northern Italy (1) to a high of 10% in gestational diabetic women from a German multicenter study (2). A study in Denmark reported an incidence of 2.2% GADa positivity in sera from gestational diabetic women (3). In all likelihood, such discrepancies can be attributed in whole or in part to distinct population characteristics and differences in laboratory methodology.
In view of the experience of the European investigators vis-a-vis the aforementioned rates of GADa positivity, we thought it would be of interest to determine the incidence of GADa in North American women. To have a reasonable basis for comparison, we elected to measure GADa in women during the time of their pregnancy rather than postpartum....