Gardner Daphne Su-Lyn, Rama Chandran Suresh, Sng Gerald Gui Ren, Carmody David
Department of Endocrinology, Singapore General Hospital, Singapore 169856, Singapore.
JCEM Case Rep. 2025 Jul 11;3(8):luaf147. doi: 10.1210/jcemcr/luaf147. eCollection 2025 Aug.
Management of hyperglycemia in glucokinase-maturity-onset diabetes of the young (-MODY) pregnancies is dependent on whether the fetus inherits the mutant allele. Current recommendations include frequent ultrasounds in the third trimester to detect excessive fetal growth, which points toward an unaffected fetus who is at risk of macrosomia and could benefit from treatment with insulin. We present a case of continuous glucose monitoring (CGM) use in -MODY pregnancy, in whom insulin treatment was initiated early. We discuss the CGM-glucometrics that associate with pregestational diabetes and how these could apply in the setting of MODY pregnancies to guide the need for insulin treatment when the fetal genotype is unknown. There remains a need to establish CGM thresholds for insulin initiation and glycemic targets in MODY pregnancies.
年轻的成年发病型糖尿病（MODY）合并妊娠时高血糖的管理取决于胎儿是否继承了突变等位基因。目前的建议包括在孕晚期频繁进行超声检查以检测胎儿过度生长，这表明胎儿未受影响但有巨大儿风险，可能受益于胰岛素治疗。我们报告一例在MODY妊娠中使用持续葡萄糖监测（CGM）的病例，该患者早期即开始胰岛素治疗。我们讨论了与孕前糖尿病相关的CGM血糖指标，以及这些指标如何应用于MODY妊娠情况，以在胎儿基因型未知时指导胰岛素治疗的需求。仍有必要确定MODY妊娠中开始胰岛素治疗的CGM阈值和血糖目标。
