Diagnosis and management of glucokinase monogenic diabetes in pregnancy: current perspectives

Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy
Victoria L Rudland

Abstract

Glucokinase-maturity-onset diabetes of the young (GCK-MODY) is an autosomal dominant disorder caused by heterozygous inactivating GCK gene mutations. GCK-MODY is one the most common MODY subtypes, affecting 0.1% of the population and 0.4-1% of women with gestational diabetes mellitus. Glucokinase is predominantly expressed in pancreatic beta cells and catalyzes the phosphorylation of glucose to glucose-6-phosphate. The unique kinetics of glucokinase enable it to change the rate of glucose phosphorylation according to the glucose concentration, thereby regulating insulin secretion. Individuals with GCK-MODY have mildly elevated fasting blood glucose levels (5.5-8.0 mmol/L) and regulate glucose perturbations to a higher set-point, resulting in a relatively flat glucose profile on a 75 g oral glucose tolerance test. The hyperglycemia is usually subclinical and may only be detected on incidental glucose testing. It is important to correctly identify GCK-MODY as the clinical course and management differs substantially from other types of diabetes. Diabetes-related complications are relatively uncommon, so glucose-lowering treatment is not usually required. The exception is pregnancy, where fetal growth and therefore glucose-lowering...Continue Reading

Citations

Dec 11, 2019·International Journal of Molecular Sciences·Lorenzo Petra IBenoit R Gauthier
Jun 5, 2020·Archives of Gynecology and Obstetrics·Jana UrbanováJan Brož
Dec 10, 2020·Clinical Diabetes and Endocrinology·Ken Munene NkongeTeresa Njeri Nkonge
Jul 25, 2021·International Journal of Molecular Sciences·Dawid SkoczekNeli Kachamakova-Trojanowska
Aug 14, 2021·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Kelly M Schiabor BarrettElizabeth T Cirulli
Aug 27, 2021·Diabetes & Metabolic Syndrome·Joana Lima FerreiraRosa Maria Príncipe

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Methods Mentioned

BETA
genotyping

Software Mentioned

MODY
GCK

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