title: Nonimmune "Fulminant" type 1 diabetes presenting with diabetic ketoacidosis during pregnancy.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Koseiren Shinonoi General Hospital, Nagano, Japan
authors.forename: Maki
authors.initials: M
authors.lastname: Otsubo
authors.forename: Tanri
authors.initials: T
authors.lastname: Shiozawa
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kimura
authors.forename: Ikuo
authors.initials: I
authors.lastname: Konishi
mesh_terms: 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