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20-11-2023 | Maturity-Onset Diabetes of the Young | Case Report

Insulin titration and blood glucose fluctuations during pregnancy in GCK-MODY: Case Report

Authors: Yilin Zhao, Tianhao Ba, Qian Ren, Xueyao Han, Linong Ji

Published in: International Journal of Diabetes in Developing Countries

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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 genotyping 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.
Literature
Metadata
Title
Insulin titration and blood glucose fluctuations during pregnancy in GCK-MODY: Case Report
Authors
Yilin Zhao
Tianhao Ba
Qian Ren
Xueyao Han
Linong Ji
Publication date
20-11-2023
Publisher
Springer India
Published in
International Journal of Diabetes in Developing Countries
Print ISSN: 0973-3930
Electronic ISSN: 1998-3832
DOI
https://doi.org/10.1007/s13410-023-01278-1
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