Autoimmunity in Gestational Diabetes Mellitus

Up to 16.2% of pregnant women have some form of hyperglycemia, and an estimated 85% of them are due to gestational diabetes mellitus (GDM). Usually, the impairment of glucose tolerance in GDM is the result of relative insulin deficiency not due to autoimmune mechanisms. But autoimmune mechanisms similar to those in classical type 1 diabetes mellitus (DM-1A) and latent autoimmune diabetes in adults also play a pathophysiological role in a subset of GDM patients. Women with autoimmune GDM are those with glucose intolerance in pregnancy depicting in their sera diabetes-related autoantibodies (DRAs). The prevalence varies depending upon study population, methodology, and type of antibody. Women with GDM who display DRA positivity have higher rates of insulin requirement and a higher risk of abnormal glucose tolerance after pregnancy, including DM-1A.