This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Gestational diabetes affects between 3-5% of all pregnancies. The pregnancies of women with gestational diabetes are more likely to be associated with complications such as pre-eclampsia-toxemia, fetal macrosomia and shoulder dystocia. Maturity onset diabetes of the young (MODY) has a clear mendelian genetic link. Previous European studies have found 4-6% prevalence of MODY among women with gestational diabetes. It has been noted that the children of gestational diabetics had a 1200 gram weight difference based on the presence or absence of the mutation which causes MODY, depending if it was present in the mother or fetus. Furthermore, studies have noted that the lifelong complications associated with MODY are less severe than typical type 1 or 2 diabetes. That is, MODY patients have less cardiovascular disease and are typically less obese than non - MODY individuals with diabetes. There have been no prospective studies to date looking at the prevalence of MODY in an urban U.S. diabetes clinic. Hence, the specific aim of this proposal will be to determine the prevalence of MODY in our High-risk pregnancy diabetes clinic. Two hundred women with diabetes in pregnancy will be studied in order to determine their clinical characteristics and pregnancy outcomes. Maternal blood samples will be obtained for evaluation of glucokinase and other beta cell mutations resulting in clinical diabetes. After delivery, blood samples will be obtained from the umbilical cord for glucokinase mutations. Anthropometric measurements will be taken on the baby.
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