A Case of Diabetes Mellitus with Anti-GAD Antibody Following Gestational Diabetes.
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概要
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The patient was a 26-year-old woman, who was first found to have glucose intolerance at 20 weeks of gestation during her 1st pregnancy. An HbA1c concentration of 8.1% was detected at 23 weeks of gestation. For treatment of the hyperglycemia, a daily dose of 80-100 units of insulin was required until delivery. A normal 2860-g infant was born at 39 weeks of gestation. In the postpartum period the patient could be treated by dietary therapy alone and the results of OGTT showed a borderline pattern (Japanese Diabetes Association) with low C-peptide levels. Glutamic acid decarboxylase (GAD) antibody was negative at that time. One year later she was pregnant again. She required insulin injections after 23 weeks of gestation. A daily dose of 60-70 units of insulin was needed to maintain a normal glucose level. At that time FPG was 94mg/d<I>l</I> and HbA1c was 5.1%. A normal 2820-g infant was born at 40 weeks of gestation. After delivery the patient needed no insulin; however, GAD antibody changed to positive (16.1U/m<I>l</I>), and OGTT showed a diabetic pattern. Her HLA genotypes were DRB 10405 and DQB 10401, which are IDDM associated types in Japan. Gestational diabetes is a heterogeneous disorder. In this case, the type of diabetes seems to be NIDDM now, but it is suspected that pancreatic β-cell dysfunction may develop in the future.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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