Objective To investigate the role ofglutamic acid decarboxylase autoantibody(GAD-Ab)and protein tyrosine phosphatase autoantibody(IA-2A) in postpartum follow-up of gestational diabetes mellitus (GDM).MethodsGAD-Ab,IA-2A,insulin and glucose metabolism index were measured in 82subjects with normal glucose tolerance (control group) and 84 patients with GDM(GDM group) during 24 to 28 weeks in pregnancy,postpartum 6 to 12 weeks and 2 years.GDM group was divided into antibodies positive group (GAD-Ah or IA-2A were positive) with 18 cases and antibodies negative group (GAD-Ab and IA-2A was negative) with 66 cases.Results Homeostasis model insulin resistance index (HOMA-IR) in GDM group was higher than that in control group (3.87 ± 2.17 vs.2.31 ± 0.52,P ＜ 0.05 ).Homeostasis β -cell function index (HBCI) and 30 min net increment of insulin/30 min net increment of glucose ( △ I30/△ G30) in GDM group were lower than those in control group[206.38 ± 138.06 vs.422.43 ± 228.93 and (20.16 ±11.38) mU/mmol vs.(26.54 ±24.30) mU/mmol,P ＜0.05].The numbers who had the family history of diabetes mellitus and the used of insulin for treatment in antibodies positive group were higher than those in antibodies negative group[ 83.3％ (15/18) vs.28.8％ (19/66) and 77.8％ ( 14/18 ) vs.30.3％ (20/66) ],HOMA-IR,△ I30/ △ G30 and HBCI in antibodies positive group were lower than those in antibodies negative group [3.20±0.84 vs.4.02±0.36,(16.81 ±2.91) mU/mmol vs.(21.55± 11.11) mU/mmol and 124.95 ± 5.03 vs.217.43 ± 115.64,P＜ 0.01 ].Fasting plasma glucose (FPG),2 hours postprandial glucose (2hPG)and glycosylated hemoglobin (HbA1c) in antibodies positive group were higher than those in antibodies negative group during postpartum 6 to 12 weeks and 2 years [postpartum 6 to 12 weeks: (8.20 ±3.11)mmol/L vs.(5.39 ±0.76) mmol/L,(15.22 ±7.29) mmol/L vs.(8.15 ± 1.93) mmol/L,(7.26 ± 1.04)％ vs.(5.88 ±0.41)％ ;postpartum 2 years: (8.91 ±2.80) mmol/L vs.(4.93 ±0.66) mmol/L,(15.75 ±7.87)mmol/L vs.(7.85 ± 1.79) mtmol/L,(7.18 ± 1.22)％ vs.(5.64 ± 0.32 )％,P ＜ 0.01].△ I30/ △ G30 and HBCI were significantly decreased in antibodies positive group postpartum 2 years.No change of the above parameters in antibodies negative group was found.The occurrence rate of type 1 diabetes mellitus (T1DM) was 16.7％(3/18) and 33.3％(6/18) postpartum 6 to 12 weeks and 2 years in antibodies positive group,there was no T1DM in antibodies negative group.ConclusionsWomen with GDM are partly associated with T1DM.Requiring insulin therapy during pregnancy and GAD-Ab or IA-2A positive have considerable risk for developing T1DM.It is also an important predictor to GDM after parturition.

Objective To explore the efficiency of continuous glucose monitoring system(CGMS) and blood glucose self-monitoring (SMBG)in evaluating blood glucose excursion in type 1 diabetes mellitus (T1DM) complicated with pregnancy. Methods Twenty-five patients having suffered from T1DM complicated with pregnancy were selected randomly during June 2012 to July 2015. All subjects underwent blood glucose monitoring by CGMS and SMBG for 72 h, including the data of blood glucose before meal, 2 h post-meal blood glucose (2hBG) and blood glucose at 2:00 AM. Results The level of the highest blood glucose in CGMS was significantly higher than that in SMBG:(10.60 ± 2.11) mmol/L vs. (7.50 ± 1.18) mmol/L, P<0.01. The level of the lowest blood glucose in CGMS was significantly lower than that in SMBG:(3.60 ± 1.06) mmol/L vs. (4.50 ± 1.15) mmol/L, P<0.01. The level of mean blood glucose in CGMS and SMBG had no significant difference:(7.20 ± 1.18) mmol/L vs. (7.30 ± 1.15) mmol/L, P>0.05. The rate of hypoglycemia(blood glucose<3.3 mmol/L) in CGMS was 4.6%, and in SMBG was 1.9%. Through adjusting the treatment by CGMS, the blood glucose before meal, 2hBG and blood glucose at 2:00 AM at 49-72 h were significantly lower than that at 0-24 h (P<0.05). Conclusions Compared with SMBG, CGMS has a relatively larger blood glucose monitoring range and can sensitively evaluate blood glucose excursion, CGMS provides a scientific basis to develop a more rational and effective strategies for controlling diabetes.