Diabetic ketoacidosis and pregnancy.
This paper describes the clinical course of a young diabetic primigravida who presented to her physician with vomiting and abdominal pain. Despite the conventional doses of intravenous fluid and insulin that were used to treat her suspected diabetic ketoacidosis, she remained severely acidotic and developed increasing abdominal pain. Two hundred twenty units of regular insulin over a 5-hour period were required to reverse the lipolysis, acidemia, and abdominal pain, which characterized her severe episode of diabetic ketoacidosis. This discussion emphasizes the importance of insulin in the reversal of the hyperglycemia and acidosis that accompany a diabetic crisis. The roles of bicarbonate, phosphorous, magnesium, insulin, potassium, and fluids are discussed along with conditions such as pregnancy, infection, pancreatitis, and abdominal pain, which can complicate the management of diabetic ketoacidosis.
Bertolino
J G
JG
Department of Family Practice, College of Medicine, University of Kentucky, Lexington 40536-0226.
D000293:Adolescent; D001639:Bicarbonates / Q000008:administration & dosage / Q000627:therapeutic use; D016883:Diabetic Ketoacidosis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007333:Insulin Resistance; D011188:Potassium / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012964:Sodium / Q000008:administration & dosage / Q000627:therapeutic use; D017693:Sodium Bicarbonate; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use
D001639:Bicarbonates; D007328:Insulin; D012965:Sodium Chloride; D017693:Sodium Bicarbonate; D012964:Sodium; D011188:Potassium