Nonimmune "Fulminant" type 1 diabetes presenting with diabetic ketoacidosis during pregnancy.
BACKGROUND
Ketoacidosis in pregnant women with previously undiagnosed diabetes is rare. Although insulin-dependent diabetes has recently been classified as either autoimmune (type 1A) or nonimmune (type 1B; "chronic" and "fulminant" subtypes), the clinical characteristics of diabetes in such settings are not fully understood.


METHODS
We report two pregnant patients with previously undiagnosed diabetes. They presented with severe diabetic ketoacidosis characterized by an abrupt onset, normal, or slightly elevated level of glycosylated hemoglobin, absence of diabetes-related autoimmune antibodies, and features typical of the "fulminant" subtype of nonimmune diabetes. The fetuses died in utero, and the mothers became insulin dependent.


CONCLUSIONS
The "fulminant" subtype of diabetes may be associated with fetal death.
Otsubo
Maki
M
Department of Obstetrics and Gynecology, Koseiren Shinonoi General Hospital, Nagano, Japan
Shiozawa
Tanri
T
Kimura
Kaoru
K
Konishi
Ikuo
I
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000503:physiopathology; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000175:diagnosis* / Q000503:physiopathology