Diabetes related autoimmunity in gestational diabetes mellitus: Is it important?

Lapolla, Annunziata; Dalfrà, Mariagrazia; Fedele, Domenico

doi:10.1016/j.numecd.2009.04.004

Cited by 53 publications

(58 citation statements)

References 86 publications

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“…In patients with GDM, general risk factors for T1D (reviewed elsewhere [10,41,42]) combine with pregnancy-related physiological changes in glucose metabolism and immune system regulation. The likelihood of GDM development is positively related to the number of risk factors present at the time of pregnancy (Fig.…”

Section: Pregnancy In Women At Risk Of T1d May Results In Autoimmune Gmentioning

confidence: 99%

“…Many researchers previously considered the pathophysiology of GDM to be similar to that of IR-mediated T2D [2], and GDM has been considered a high-risk factor for T2D development later in life in up to 70 % of affected women [8]. More recently, however, growing evidence has indicated that GDM is similar to autoimmune T1D or latent autoimmune diabetes of adults (LADA) in a proportion of patients [9], as reviewed comprehensively by Lapolla and colleagues in 2009 [10]. In the worst-case scenario, half of affected patients will develop autoimmune diabetes a few years after index pregnancy [11].…”

mentioning

confidence: 99%

“…In the worst-case scenario, half of affected patients will develop autoimmune diabetes a few years after index pregnancy [11]. In addition, discrimination between GDM and other types of diabetes that were previously undiagnosed or develop coincidentally at the time of pregnancy represents a diagnostic challenge during pregnancy [10].…”

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confidence: 99%

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Clinical Recommendations for the Use of Islet Cell Autoantibodies to Distinguish Autoimmune and Non-Autoimmune Gestational Diabetes

Haller-Kikkatalo

Uibo

2014

Clinic Rev Allerg Immunol

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Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. The prevalence of GDM is highly variable, depending on the population studied, and reflects the underlying pattern of diabetes in the population. GDM manifests by the second half of pregnancy and disappears following delivery in most cases, but is associated with the risk of subsequent diabetes development. Normal pregnancy induces carbohydrate intolerance to favor the availability of nutrients for the fetus, which is compensated by increased insulin secretion from the maternal pancreas. Pregnancy shares similarities with adiposity in metabolism to save energy, and both conditions favor the development of insulin resistance (IR) and low-grade inflammation. A highly complicated network of modified regulatory mechanisms may primarily affect carbohydrate metabolism by promoting autoimmune reactions to pancreatic β cells and affecting insulin function. As a result, diabetes development during pregnancy is facilitated. Depending on a pregnant woman's genetic susceptibility to diabetes, autoimmune mechanisms or IR are fundamental to the development autoimmune or non-autoimmune GDM, respectively. Pregnancy may facilitate the identification of women at risk of developing diabetes later in life; autoimmune and non-autoimmune GDM may be early markers of the risk of future type 1 and type 2 diabetes, respectively. The most convenient and efficient way to discriminate GDM types is to assess pancreatic β-cell autoantibodies along with diagnosing diabetes in pregnancy.

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Section: Pregnancy In Women At Risk Of T1d May Results In Autoimmune Gmentioning

confidence: 99%

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confidence: 99%

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Clinical Recommendations for the Use of Islet Cell Autoantibodies to Distinguish Autoimmune and Non-Autoimmune Gestational Diabetes

Haller-Kikkatalo

Uibo

2014

Clinic Rev Allerg Immunol

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“…Inclusion criteria (Lapolla et al, 2009): 1) T2DM diagnosis as defined by the diagnostic criteria published by the World Health Organization (WHO) in 1999; 2) data in the enrolled cohort and case-control studies were original instead of cited; 3) all of the data related to genotypes are complete and can be used for further statistical calculations; 4) single data from the same race at the same research period (time); 5) patients were randomly selected and the general data (such as the age, sex, occupation etc.) had no strict limits; 6) literature must have been published within the year limits described above; 7) and a sufficient level of data must have been available for calculation of the OR value and the 95%CI calculation.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Meta-analysis of the association between the rs7903146 polymorphism at the TCF7L2 locus and type 2 diabetes mellitus susceptibility

Xh¹,

Cg²,

An³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. Type 2 diabetes mellitus (T2DM) is a chronic disease caused by genetic and environmental factors. T2DM has been associated with specific polymorphisms in the TCF7L2 gene. This study evaluates the relationship between the rs7903146 locus polymorphism of the TCF7L2 gene and T2DM susceptibility through meta-analysis; the overall aim is to provide a basis for evidence-based medicinal treatment of T2DM. Cohort and case-control studies from Medline, PubMed, EMBASE, CBM, CNKI, and academic conferences/dissertations that examined the correlation between T2DM and rs7903146 polymorphisms were evaluated. We determined whether the TCF7L2 rs7903146 locus was associated with T2DM susceptibility by comparing alleles and genotypes. The Stata 11.0 software was applied for meta-analysis, and a random-effects model was adopted for heterogeneity testing and odds ratio (OR) calculation. A fixed-effect model was used for quantitative analysis of the heterogeneity between different studies, and for calculating the percentage of variability 16857 rs7903146 polymorphism in TCF7L2 and type 2 diabetes mellitus ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (4): 16856-16862 (2015) I 2 . A total of 10 studies related to the rs7903146 loci and T2DM susceptibility were enrolled; this included 3404 cases of T2DM patients and 6473 control cases. Meta-analysis showed that the T allele of rs7903146 was significantly correlated with the risk of T2DM, with both a dominant fixedeffect model (OR = 1.653, 95%CI = 1.416-1.653) and a co-dominant-fixed effect model (OR = 1.525, 95%CI = 1.350-1.723). Meta-analysis revealed that the T allele of rs7903146 was also correlated with T2DM susceptibility.

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“…In women with GDM, the determination of different specific antibodies against pancreatic beta cells, like antibodies to islet cells (ICA), glutamic acid decarboxilase antibodies (GADA), tyrosine phosphatase tyrosine (IA-2A), and most recently, GAD 65, proven preclinical markers of type 1 diabetes (Mitchell et al, 2000;Murgia et al, 2008), has allowed to know that autoimmune GDM corresponds to 10% of GDM cases in Caucasian women and contributes to a peculiar and complex pre-diabetic state, with a high risk for progressing to type 1 diabetes and to a latent autoimmune diabetes of adulthood (LADA) (de Leiva et al, 2007;Lapolla et al, 2009). The risk increases with the number of antibodies present (Füchtenbusch et al, 1997), and is higher during the first postpartum years (Nilsson et al, 2007).…”

Section: Type 1 Diabetesmentioning

confidence: 99%

Gestational Diabetes Mellitus After Delivery

Rivas¹

2011

Gestational Diabetes

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Diabetes related autoimmunity in gestational diabetes mellitus: Is it important?

Cited by 53 publications

References 86 publications

Clinical Recommendations for the Use of Islet Cell Autoantibodies to Distinguish Autoimmune and Non-Autoimmune Gestational Diabetes

Clinical Recommendations for the Use of Islet Cell Autoantibodies to Distinguish Autoimmune and Non-Autoimmune Gestational Diabetes

Meta-analysis of the association between the rs7903146 polymorphism at the TCF7L2 locus and type 2 diabetes mellitus susceptibility

Gestational Diabetes Mellitus After Delivery

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