Series 3 episode 6. Gill Preston, Gill Spyer, and Ali Chakera The challenge of diagnosing and managing glucokinase MODY in pregnancy

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It was a great surprise for Gill Preston, who was active and slim, when she was diagnosed with gestational diabetes in her first pregnancy. Her raised fasting glucose did not come down with tablets or insulin. Luckily she met Andrew Hattersley in the diabetes pregnancy clinic, who recognised she had glucokinase MODY. Gill Spyer, working for her PhD as a research doctor showed that in glucokinase pregnancy the size of the baby depended on whether they inherited the genetic change from the mother and was not altered by insulin treatment. When the baby had the mutation it would grow normally and no treatment of the mother was needed. Ali Chakera continued research into glucokinase pregnancy; his research showed that slim women ( BMI <25) with a raised fasting glucose of above 5.5mmol/l had a 1 in 3 chance of having GCK MODY and should be tested. He also looked into genetic testing the fetus directly rather than trying to infer from fetal growth on ultrasound.

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