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Glucokinase deficit and birthweight: does maternal hyperglycemia always meet fetal needs?

Abstract：

AIMS:Many authors do not recommend hypoglycemic treatment during pregnancy in women affected by monogenic diabetes due to heterozygous glucokinase (GCK) mutations (MODY 2) in case of affected fetus, because maternal hyperglycemia would be necessary to achieve a normal birthweight. We aimed to evaluate differences in birthweight between MODY 2 affected children according to the parent who carried the mutation. METHODS:We retrospectively studied 48 MODY 2 affected children, whose mothers did not receive hypoglycemic treatment during pregnancy, divided into two groups according to the presence of the mutation in the mother (group A) or in the father (group B). Data were extracted from the database of the Regional Centre of Pediatric Diabetology of the University of Campania, Naples, collected from 1996 to 2016. We analyzed birthweight and centile birthweight. RESULTS:Percentage of small for gestational age was significantly higher in group B than in group A. We found three large for gestational age in the group that inherited the deficit from the mother, all with the same novel GCK mutation (p.Lys458-Cys461del). CONCLUSIONS:We hypothesize that not all MODY 2 affected fetuses need the same levels of hyperglycemia to have an appropriate growth, maybe because different kinds of GCK mutations may result in different phenotypes. Consequently, a "tailored therapy" of maternal hyperglycemia, based on fetal growth frequently monitored through ultrasounds, is essential in MODY 2 pregnancies.

journal_name

Acta Diabetol

journal_title

Acta diabetologica

authors

Bitterman O,Tinto N,Franzese A,Iafusco F,Festa C,Mozzillo E,Napoli A,Iafusco D

doi

10.1007/s00592-018-1198-8

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

1247-1250

issue

12

eissn

0940-5429

issn

1432-5233

pii

10.1007/s00592-018-1198-8

journal_volume

55

pub_type

杂志文章

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