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- Title
Identifying Glucokinase Monogenic Diabetes in a Multiethnic Gestational Diabetes Mellitus Cohort: New Pregnancy Screening Criteria and Utility of HbA1c.
- Authors
Rudland, Victoria L.; Hinchcliffe, Marcus; Pinner, Jason; Cole, Stuart; Mercorella, Belinda; Molyneaux, Lynda; Constantino, Maria; Yue, Dennis K.; Ross, Glynis P.; Wong, Jencia
- Abstract
<bold>Objective: </bold>Glucokinase monogenic diabetes (GCK-maturity-onset diabetes of the young [MODY]) should be differentiated from gestational diabetes mellitus (GDM) because management differs. New pregnancy-specific screening criteria (NSC) have been proposed to identify women who warrant GCK genetic testing. We tested NSC and HbA1c in a multiethnic GDM cohort and examined projected referrals for GCK testing.<bold>Research Design and Methods: </bold>Using a GDM database, 63 of 776 women had a postpartum oral glucose tolerance test suggestive of GCK-MODY. Of these 63 women, 31 agreed to undergo GCK testing. NSC accuracy and HbA1c were examined. Projected referrals were calculated by applying the NSC to a larger GDM database (n = 4,415).<bold>Results: </bold>Four of 31 women were confirmed as having GCK-MODY (prevalence ∼0.5-1/100 with GDM). The NSC identified all Anglo-Celtic women but did not identify one Indian woman. The NSC will refer 6.1% of GDM cases for GCK testing, with more Asian/Indian women referred despite lower disease prevalence. Antepartum HbA1c was not higher in those with GCK-MODY.<bold>Conclusions: </bold>The NSC performed well in Anglo-Celtic women. Ethnic-specific criteria should be explored.
- Subjects
GLUCOKINASE; DIABETES; COHORT analysis; GLUCOSE tolerance tests; DISEASE prevalence; GENETIC testing; DATABASES; TYPE 2 diabetes diagnosis; ASIANS; DIFFERENTIAL diagnosis; GESTATIONAL diabetes; GLYCOSYLATED hemoglobin; TYPE 2 diabetes; PUERPERIUM; TRANSFERASES; WHITE people; DIAGNOSIS
- Publication
Diabetes Care, 2016, Vol 39, Issue 1, p50
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/dc15-1001