AJOG Reviews: Case ReportsInfluence of maternal and fetal glucokinase mutations in gestational diabetes☆,☆☆
Section snippets
Case report
A 26-year-old woman was reviewed at 12 weeks of gestation during her first pregnancy because of persisting glycosuria. She was obese (body mass index, 39 kg/m2) and oral glucose tolerance testing confirmed impaired fasting glucose (fasting plasma glucose, 6.1 mmol/L; 1 hour, 12.2 mmol/L, and 2 hours, 6.9 mmol/L). She was treated initially with diet and subsequently insulin (up to 1 U/kg/d) from week 12. Glycemic control was assessed by serum fructosamine on 6 occasions between 18 and 35 weeks
Comment
We report 2 pregnancies in a patient with hyperglycemia resulting from a mutation in the glucokinase gene. Glucokinase mutations are found in approximately 3% of white women with gestational diabetes and are likely in patients with persistent fasting hyperglycemia, a small increment during an oral glucose tolerance test, and requiring insulin treatment during pregnancy.1 The mild phenotype (fasting blood glucose, 5.5-9 mmol/L from birth) means many of these patients will not be identified until
Acknowledgements
We thank Diabetes UK for funding the genetic analysis.
References (3)
- et al.
A high prevalence of glucokinase mutations in gestational diabetic subjects by clinical criteria
Diabetologia
(2000)
Cited by (0)
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Ghislaine Spyer, MBBS, is the recipient of a fellowship awarded by Novo Nordisk.
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Reprint requests: Ghislaine Spyer, MBBS, Department of Diabetes and Vascular Medicine, School of Postgraduate Medicine, Barrack Road,Exeter, UK.