The changing presentations of diabetic ketoacidosis during pregnancy.
The purpose of the present study was to examine the presentation and outcomes associated with diabetic ketoacidosis (DKA) in pregnancies complicated by diabetes. Eleven episodes (2%) of DKA were diagnosed during the 10-year study period. All patients were under close observation by the Diabetes-in-Pregnancy Service. Plasma glucose levels of less than 200 mg/dL were present in 4 of the 11 patients (36%), 10 (90%) of whom presented with nausea, vomiting, and decreased caloric intake. Two subsequently had fetal distress necessitating cesarean section. One fetal death occurred in a patient treated with subcutaneous insulin. Despite contemporary methods of diabetes care, near-normal plasma glucose levels are not enough to preclude diabetic ketoacidosis. Nausea, vomiting, and decreased caloric intake in an otherwise normal pregnant, diabetic woman requires evaluation to exclude ketosis.
Cullen
M T
MT
Department of Obstetrics and Gynecology at Yale University School of Medicine, New Haven, Connecticut, USA.
Reece
E A
EA
Homko
C J
CJ
Sivan
E
E
D016640:Diabetes, Gestational / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D011247:Pregnancy; D011254:Pregnancy in Diabetics
D007004:Hypoglycemic Agents; D007328:Insulin