Abstract
Background
Glucokinase-maturity onset diabetes of the young (GCK-MODY) is a form of monogenic diabetes that is caused by heterozygous inactivating mutations in GCK gene. The management of GCK-MODY during pregnancy is challenging, as pharmacological treatment dose could not alter glycaemia in GCK-MODY in longitudinal studies and noninvasive antenatal fetal GCK genoty** is unavailable.
Case presentation
Here, we report a case of GCK-MODY with pregnancy. The patient was 41 years old. She was diagnosed with GCK-MODY at 10 weeks of gestation. At 22 weeks and 6 days of gestation, she underwent amniocentesis due to her advanced age and genetic testing confirmed that the fetus was a heterozygous mutation carrier. We described the characteristics of blood glucose fluctuation, insulin responsiveness, hypoglycemic risk, fetal development, and pregnancy outcome before and after fetus genetic testing during her entire pregnancy. Until now, there were no studies describing insulin titration and blood glucose fluctuations during pregnancy in patients with GCK-MODY.
Conclusion
Our case indicted that insulin therapy during pregnancy is effective in GCK-MODY. Careful dietary modifications, individualized insulin titration and specialized diabetes education can reduce the risk of hypoglycemia and improve gestational outcome in GCK-MODY with pregnancy.
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All data generated or analyzed during this study are included in this published article.
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Acknowledgments
We thank the patient for agreeing to participant in this study.
Funding
This work was supported by Peking University People's Hospital Research and Development Fund (grant No.RDL2022-20) and Bei**g Municipal Commission of Science and Technology (grant Z201100005520012).
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Y.Z. collected and organized the data and drafted the manuscript. T.B. and Q.R. provided recommendations for statistical analyses. Q.R., X.H and L.J. critically reviewed the manuscript. Q. R. and L.J. are the guarantor of this work, and had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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The study protocol was approved by the Ethics Committee of Peking University People’s Hospital (China). Written informed consent was obtained from the patient.
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Zhao, Y., Ba, T., Ren, Q. et al. Insulin titration and blood glucose fluctuations during pregnancy in GCK-MODY: Case Report. Int J Diabetes Dev Ctries (2023). https://doi.org/10.1007/s13410-023-01278-1
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DOI: https://doi.org/10.1007/s13410-023-01278-1