Gestational diabetes & diabetes in pregnancy
Pregnancy and neonatal outcomes in women with GCK-MODY: an observational study based on standardised insulin modalities
Authors' conclusion
In our study, the rate of LGA primarily depended on the fetal GCK genotype rather than the treatment strategy or glycaemic management. Our results suggest that a standardised strategy based on ultrasound monitoring of fetal growth and glycaemic safety thresholds, leading to delayed insulin initiation, offers a good fetal prognosis and minimises the risk of maternal hypoglycaemia.
Study context
- Population
- Pregnant women with GCK-MODY
- Participants
- 25 vs 21
- Exposure
- Insulin started on maternal glycaemia thresholds vs on fetal growth
- MGn = 25
- FGn = 21reference
- Outcome
- Pregnancy and neonatal outcomes
Main finding
As reported in the abstract
- No differences in pregnancy and neonatal outcomes between MG and FG
Observational data: associations, not effects.
Further findings
Insulin initiation · more frequent with MG
P = 0.01
| Outcome | P value |
|---|---|
| LGA by neonatal GCK genotypeNeonates with GCK variant vs Neonates without GCK variant | P = 0.005 |
- Insulin initiation — Insulin initiated earlier with MG
- p=0.001
- Large for gestational age (LGA) by neonatal GCK genotype: Neonates with GCK variant 0%
- LGA by neonatal GCK genotype: Neonates without GCK variant 36%
Insulin initiation
- Lower capillary blood glucose (CBG) with MG vs FG
LGA, preterm delivery and Caesarean section (total cohort)
- LGA
- 22.2%
- Preterm deliveries
- 2.2%
- Caesarean sections
- 40%
LGA by neonatal GCK genotype
- No associations between LGA and pregnancy characteristics, insulin strategy or glycaemic management
Safety
Maternal hypoglycaemic episodes
- More frequent hypoglycaemic episodes with MG vs FG
Original publication
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