{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:17:54Z","timestamp":1783448274794,"version":"3.55.0"},"reference-count":13,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":165,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Activating mutations in the ABCC8 gene are extremely rare and cause ABCC8-MODY. The phenotype is variable with onset of diabetes in childhood\/early adulthood. Retinopathy is the most common reported complication. We describe a 31-year-old primigravida woman referred to and seen at our antenatal ambulatory diabetes clinic at 6 weeks plus 5 days gestation. She had a strong family history of diabetes and was diagnosed at the age of 11 years. Genetic testing revealed an activating pathogenic c.4139G&amp;gt;A variant in the ABCC8 gene. She was managed with glibenclamide, sitagliptin, and dapagliflozin. Her complications included mild bilateral non-proliferative retinopathy and necrobiosis lipoidica. Her BMI was 19 kg\/m2, and HbA1c was 68 mmol\/mol. Oral agents were discontinued, and insulin therapy was commenced. At 22 weeks gestation, routine retinal screening identified progression to bilateral active proliferative diabetic retinopathy (time in range for pregnancy (TIRp) 68%, HbA1c 39 mmol\/mol). She received four sessions of panretinal photocoagulation (PRP) bilaterally between 22 and 33 weeks gestation. There was no associated loss of vision or nephropathy. TIRp was \u226570% for the remainder of the pregnancy. She delivered a 3.9 kg unaffected female infant at 38 weeks via elective caesarean section without maternal or neonatal complications. Bilateral active proliferative retinopathy persisted up to 61 weeks postnatally and required additional PRP. Forty-six weeks post-partum, after ceasing breastfeeding, insulin was switched to glibenclamide and dapagliflozin. This is the first case report of rapid progression of clinically significant diabetic retinopathy during pregnancy in a woman with ABCC8-MODY. This is an unusual finding as there is a relatively low risk of significant progression of diabetic retinopathy in women with type 2 diabetes during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1530\/edm-25-0149","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:11:06Z","timestamp":1770811866000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["Progression of diabetic retinopathy during pregnancy in a woman with ABCC8-MODY"],"prefix":"10.1530","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5578-5496","authenticated-orcid":true,"given":"Patrick","family":"McCluskey","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mair\u00e9ad T","family":"Crowley","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmina","family":"Barac","sequence":"additional","affiliation":[{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kennelly","sequence":"additional","affiliation":[{"name":"3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria M","family":"Byrne","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"2026070713533946700_bib1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s00125-011-2319-x","article-title":"Heterozygous ABCC8 mutations are a cause of MODY","volume":"55","author":"Bowman","year":"2012","journal-title":"Diabetologia"},{"key":"2026070713533946700_bib2","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.trsl.2020.10.003","article-title":"The antidiabetic drug glibenclamide exerts direct retinal neuroprotection","volume":"229","author":"Berdugo","year":"2021","journal-title":"Transl Res"},{"key":"2026070713533946700_bib3","first-page":"876","article-title":"Phenotype, genotype and glycaemic variability in people with activating mutations in the ABCC8 gene: response to appropriate therapy","volume":"35","author":"Reilly","year":"2019","journal-title":"Diabet Med"},{"key":"2026070713533946700_bib4","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/pedi.12826","article-title":"Phenotypic variability in two siblings with monogenic diabetes due to the same ABCC8 gene mutation","volume":"20","author":"Cattoni","year":"2019","journal-title":"Pediatr Diabetes"},{"key":"2026070713533946700_bib5","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3459","article-title":"ABCC8 variants in MODY12: review of the literature and report of a case with severe complications","volume":"37","author":"Timmers","year":"2021","journal-title":"Diabetes Metab Res Rev"},{"key":"2026070713533946700_bib6","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s13300-016-0192-9","article-title":"ABCC8-relared maturity-onset diabetes of the young (MODY12): clinical features and treatment perspective","volume":"7","author":"Ovsyannikova","year":"2016","journal-title":"Diabetes Ther"},{"key":"2026070713533946700_bib7","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1111\/ceo.14410","article-title":"Progression of diabetic retinopathy in women with pregestational diabetes during pregnancy and postpartum","volume":"53","author":"Widyaputri","year":"2024","journal-title":"Clin Exp Opthalmol"},{"key":"2026070713533946700_bib8","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.2337\/dc16-0024","article-title":"Persistent effects of intensive glycemic control on retinopathy in type 2 diabetes in the action to control cardiovascular risk in diabetes (ACCORD) follow-on study","volume":"39","author":"Action to Control Cardiovascular Risk in Diabetes Follow-On (ACCORDION) Eye Study Group and The Action to Control Cardiovascular Risk in Diabetes Follow-On (ACCORDION) Study Group","year":"2016","journal-title":"Diabetes Care"},{"key":"2026070713533946700_bib9","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.2337\/dc22-2521","article-title":"Rapid reduction of HbA1c and early worsening of diabetic retinopathy: a real-world population-based study in subjects with type 2 diabetes","volume":"46","author":"Sim\u00f3","year":"2023","journal-title":"Diabetes Care"},{"key":"2026070713533946700_bib10","doi-asserted-by":"crossref","first-page":"S306","DOI":"10.2337\/dc25-S015","article-title":"15. Management of diabetes in pregnancy: standards of care in diabetes \u2013 2025","volume":"58","author":"American Diabetes Association Professional Practice Committee","year":"2025","journal-title":"Diabetes Care"},{"key":"2026070713533946700_bib11","article-title":"Effects of the ABCC8 R1420H loss-of-function variant on beta-cell function, diabetes incidence, and retinopathy","volume":"11","author":"Arreola","year":"2023","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2026070713533946700_bib12","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2023.1132772","article-title":"Severe nephrotic syndrome and early end-stage diabetic kidney disease in ABCC8-MODY12: a case report","volume":"14","author":"Schmidt","year":"2023","journal-title":"Front Genet"},{"key":"2026070713533946700_bib13","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.2337\/dc24-1862","article-title":"Improved neurodevelopment following in utero sulfonylurea exposure in a patient with KCNJ11 permanent neonatal diabetes: future implications for targeted treatment during pregnancy","volume":"48","author":"Bowman","year":"2025","journal-title":"Diabetes Care"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2026\/1\/EDM-25-0149.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2026\/1\/EDM-25-0149.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/edm\/article-pdf\/doi\/10.1530\/EDM-25-0149\/504788\/edm-25-0149.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/edm\/article-pdf\/doi\/10.1530\/EDM-25-0149\/504788\/edm-25-0149.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:54:06Z","timestamp":1783446846000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/edm\/article\/2026\/1\/EDM250149\/75390\/Progression-of-diabetic-retinopathy-during"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1530\/edm-25-0149","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]},"article-number":"EDM250149"}}