Summary
It is estimated that up to 3 % of patients with gestational diabetes have glucokinase diabetes, termed also maturity-onset diabetes of the young type 2. The disorder has autosomal dominant inheritance. There is a 50 % risk of transmission of the gene to next generation. Two scenarios with different approach to the treatment may occur in pregnancy with glucokinase diabetes: either the fetus inherits the glucokinase mutation and the treatment of maternal hyperglycemia by insulin could increase the risk of fetal growth restriction, or the fetus is without glucokinase gene mutation and untreated hyperglycemia of the mother increases the risk of macrosomia and perinatal morbidity and insulin therapy is necessary. This article describes the outcome of two pregnancies in a patient with monogenic diabetes with glucokinase deficiency. A specific approach to the treatment is discussed.
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References
Lebl J, Průhová Š. Monogenně podmíněné formy DM. In: Škrha J et al., editors. Diabetologie. 1st ed. Praha: Galen; 2009. pp. 119–22.
Ellard S, Beards F, Allen LIS, et al. A high prevalence of glucokinase mutations in gestational diabetic subjects selected by clinical criteria. Diabetologia. 2000;43:250–3.
Stride A, Vaxillaire M, Tuomi T, et al. The genetic abnormality in the beta cell determines the response to an oral glucose load. Diabetologia. 2002;45(3):427–35.
Ray JG, O’Brien TE, Chan WS. Preconception care and the risk of congential anomalies in the offspring of women with diabetes mellitus: a meta analysis. Q J Med. 2001;94:435–44.
Lebl J, Průhová Š. Monogenní diabetes mellitus: od genetiky kléčbě. Praha: Maxdorf; 2009. pp. 13–15.
Hattersley AT, Beards F, Ballantyne E, et al. Mutations in the glucokinase gene of the fetus result in reduced birth weight. Nat Genet. 1998;19:268–70.
Tartaglia E, Iafusco D, Giuliano P, et al. Comment on: Chakera et al. Antenatal diagnosis of fetal genotype determines if maternal hyperglycemia due to a glucokinase mutation requires treatment. Diabetes Care. 2013;36:14.
Spyer G, Macleod KM, Shepherd M, et al. Pregnancy outcome in patients with raised blood glucose due to a heterozygous glucokinase gene mutation. Diabet Med. 2009;26:14–18.
Chakera A, Carleton V, Ellard S, et al. Antenatal diagnosis of fetal genotype determines if maternal hyperglycemia due to a glucokinase mutation requires treatment. Diabetes Care. 2012;35(9):1832–4.
Chiu RW, Chan KC, Gao Y, et al. Noninvasive prenatal diagnosis of fetal chromosomal aneuploidy by massively parallel genomic sequencing of DNA in maternal plasma. Proc Natl Acad Sci U S A. 2008;105:20458–63.
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Haladová, I., Čechurová, D., Lacigová, S. et al. Monogenic glucokinase diabetes and pregnancy: a case study. Wien Klin Wochenschr 127, 494–496 (2015). https://doi.org/10.1007/s00508-015-0795-6
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DOI: https://doi.org/10.1007/s00508-015-0795-6