The aim of this study was to stratify risk for postpartum diabetes in women who have gestational diabetes. Women with gestational diabetes were recruited between 1989 and 1999, and 302 were followed with oral glucose tolerance tests at 9 months and 2, 5, 8, and 11 years postpregnancy. The 8-year postpartum diabetes risk was 52.7% (130 diabetic cases). Risk was increased in women with autoantibodies to GAD and/or insulinoma antigen-2 (adjusted hazard ratio 4.1; P < 0.0001), women who required insulin during pregnancy (4.7; P < 0.0001), women with BMI >30 kg/m 2 (1.5; P ‫؍‬ 0.04), and women with more than two prior pregnancies (2.5; P ‫؍‬ 0.02). Women without these risk factors had a postpartum diabetes risk of 14% by 8 years, and risk rose incrementally to 96% by 8 years in autoantibody-positive women. Parity status, C-reactive protein concentration, a diabetes family history, maternal age, weeks of gestation, and the child's birth weight did not significantly affect risk in multivariate analysis. Prospective diabetes assessment is indicated and intervention should be considered in women with gestational diabetes who are autoantibody positive, require insulin treatment during pregnancy, or are obese. Diabetes 55:792-797, 2006 G estational diabetes mellitus (GDM) complicates ϳ4% of pregnancies and is defined as glucose intolerance with onset or first diagnosis during pregnancy (1). GDM substantially increases the risk to develop postpartum diabetes and thus identifies a high-risk population for the development of both type 1 and type 2 diabetes. Risk estimates of type 2 diabetes after GDM vary from 17 to 63% within 5-16 years after pregnancy, depending upon the ethnic background of the study population and the detection method for GDM and glucose intolerance (2-4). Like type 2 diabetes, the incidence of postpartum diabetes appears to be increasing (5). Reported risk factors for postpartum diabetes include the detection of islet autoantibodies (6,7), insulin treatment during pregnancy, BMI, and age at delivery (3).The German GDM study has prospectively followed patients with GDM for up to 11 years for the purpose of estimating diabetes risk and identifying factors that modify risk. Here we report diabetes risk with respect to anthropometric markers such as BMI, insulin requirement during pregnancy, family history of diabetes, the number of previous pregnancies, age at delivery, duration of gestation, or birth weight of child and serological markers such as the presence of islet autoantibodies and serum concentrations of C-reactive protein (CRP) in this cohort. RESEARCH DESIGN AND METHODSThe German GDM prospective study follows women with GDM from delivery (6,8). Between 1989 and 1999, 302 patients with GDM were recruited from hospitals in Germany and participated in at least one follow-up contact after delivery. GDM was diagnosed following the criteria of the German Diabetes Association using an oral glucose tolerance test (OGTT) with 75-g glucose load. Women were considered to have GDM if two of three capillary bl...

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Using a variant of the laser photoelectron attachment (LPA) method with an extended energy range (EXLPA), we have studied low-energy electron attachment to the molecules CCl4 (Cl− and Cl−2 formation) and SF6 (SF−6 and SF−5 formation) in a diffuse gas target (TG = 300 K) from 0 eV up to 2 eV at energy widths down to 14 meV. In the EXLPA method, pulses of near-zero energy photoelectrons are produced in a guiding magnetic field, accelerated by a weak electric field, brought to the energy of interest prior to their traversal through the target region and subsequently accelerated and deflected onto a detecting plate. Anions due to electron attachment are extracted by a pulsed electric field, during which the photoelectron current is interrupted, and detected by a quadrupole mass spectrometer. The EXLPA anion yields are combined with absolute cross sections, obtained at very high resolution (≈1 meV) with the LPA method over the range 0–0.17 eV, to yield new recommended absolute partial and total attachment cross sections over the range 0–2 eV at the well-defined gas temperature TG = 300 K. Our cross sections show characteristic deviations from previously reported results. At least in part, these differences can be attributed to the fact that in the earlier electron beam experiments the gas temperature was higher than 300 K. For SF6, the branching fractions for SF−5 formation at electron energies 0.002–0.43 eV and for different initial rovibrational distributions are compared with those recently predicted from kinetic modelling within the framework of statistical unimolecular rate theory. Satisfactory agreement is observed, but our data provide evidence that an additional path for producing SF−6 and SF−5 ions is available at electron energies above about 0.3 eV.

Mothers with Type 1 diabetes breastfeed their children less than international recommendations. Counselling to increase frequency and duration of breastfeeding may be warranted in this population.

Aims/hypothesis The risk of type 1 diabetes is reduced in the children of mothers with type 1 diabetes compared with children of fathers with type 1 diabetes. We asked whether children of mothers with type 1 diabetes also have a decreased risk of developing islet autoantibodies, and which factors associated with maternal diabetes contribute to a reduced islet autoantibody risk in offspring. Methods Singleton offspring of a mother (n=1,008) or father with type 1 diabetes (n=578) from the BABYDIAB study were included. Children were followed from birth for the development of islet autoantibodies defined as two or more autoantibodies to insulin, glutamic acid decarboxylase or insulinoma antigen 2 in two or more blood samples. Results Islet autoantibody risk was lower in children of mothers with type 1 diabetes (5 year risk, 3.2% vs 5.7% in children of fathers with type 1 diabetes; p=0.04). Among factors that differed between pregnancies from mothers with and without type 1 diabetes, birthweight was associated with islet autoantibody risk. Risk was reduced in children with birthweights in the lower (adjusted HR 0.33; 95% CI 0.14-0.75; p=0.009) and upper (HR 0.45; 95% CI 0.21-0.97; p=0.04) tertiles compared with the middle tertile. A sub-analysis of maternal HbA 1c suggested that moderately elevated third trimester maternal HbA 1c was also associated with a reduced islet autoantibody risk in children of mothers with type 1 diabetes (5.7-7%; HR 0.38; 95% CI 0.15-0.96; p=0.04 vs children of mothers with HbA 1c <5.7%). Conclusions/interpretation The risk of islet autoimmunity is modified by maternally influenced events such as birthweight.