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Influence of maternal and fetal glucokinase mutations in gestational diabetes
G Spyer1, A T Hattersley, J E Sykes
1Department of Diabetes and Vascular Medicine, School of Postgraduate Medicine, Royal Devon and Exeter Hospital, Barrack Road, Exeter, UK.
Insights
Glucokinase gene mutations can cause hyperglycemia during pregnancy. Inherited mutations in offspring can lead to reduced fetal growth by affecting insulin secretion, impacting obstetric care.
Area of Science:
- Genetics
- Endocrinology
- Reproductive Medicine
Background:
- Glucokinase (GCK) gene mutations are associated with hyperglycemia.
- Gestational diabetes and its impact on fetal development require careful management.
Observation:
- Two pregnancies in a mother with GCK gene mutation-related hyperglycemia were managed with insulin.
- One child inherited the GCK mutation, exhibiting significantly reduced intrauterine growth (birth weight < 1st percentile).
Findings:
- The inherited GCK mutation in the child impaired fetal insulin secretion.
- This impairment directly correlated with the observed severe intrauterine growth restriction.
Implications:
- Obstetric management strategies need to consider GCK mutations in pregnant patients.
- Genetic counseling and monitoring are crucial for pregnancies affected by GCK mutations.
Abstract:
We report 2 insulin-treated pregnancies in a mother with hyperglycemia resulting from a glucokinase gene mutation. The inheritance of a glucokinase mutation in 1 child reduced his intrauterine growth (birth weight less than first percentile) by reducing fetal insulin secretion. We discuss the implications for obstetric management of patients with glucokinase mutations.