Identification of MODY among patients screened for gestational diabetes: a clinician's guide

Arch Gynecol Obstet. 2020 Aug;302(2):305-314. doi: 10.1007/s00404-020-05626-y. Epub 2020 Jun 3.

Abstract

Purpose: Screening of gestational diabetes/GDM (although different in different countries) represents a standard procedure allowing to identify women with pregnancy-associated diabetes. Some of the women with GDM (up to 5%) may, however, suffer from previously undiagnosed MODY (Maturity-Onset Diabetes of the Young). Currently, no international or local guidelines focused on the identification of MODY among GDM exist. Thus, the aim of this manuscript is to propose a clear guide for clinicians on how to detect MODY among pregnant women with gestational diabetes.

Methods: Based on the available literature about diagnosis (in general population) of MODY and management of MODY (both, in general population and in pregnant women), we propose a clear clinical guide on how to diagnose and manage MODY in pregnancy.

Results: The manuscript suggests a feasible clinical approach how to recognize MODY among patients with GDM and how to manage pregnancy of women with three most common MODY subtypes.

Conclusion: A correct classification of diabetes is, nonetheless, essential, particularly in case of MODY, as the management of pregnant women with MODY is different and the correct diagnosis of MODY enables individualized treatment with regard to optimal pregnancy outcomes.

Keywords: GCK; Gestational diabetes; HNF; MODY; Screening.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes, Gestational / blood
  • Diabetes, Gestational / diagnosis*
  • Diabetes, Gestational / epidemiology
  • Female
  • Glucokinase / genetics*
  • Glycated Hemoglobin / analysis*
  • Humans
  • Mutation
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy in Diabetics

Substances

  • Glycated Hemoglobin A
  • Glucokinase

Supplementary concepts

  • Mason-Type Diabetes