ABSTRACT
Diabetic ketoacidosis (DKA) is a serious complication of diabetes resulting often in a medical emergency. The occurrence of DKA is rare in pregnant women with diabetes, occurring mainly in patients with type 1 diabetes, but also in type 2 or, more rarely, in women with gestational diabetes mellitus. DKA is a complex metabolic disorder characterized by hyperglycemia, acidosis, and ketonemia. It frequently occurs as a consequence of absolute or relative insulin deficiency accompanied by an increased secretion of the counterregulatory hormones. Pregnancy is characterized by insulin resistance, accelerated starvation, and respiratory alkalosis, especially in the second and third trimesters. It has been demonstrated that sensitivity to insulin decreases in pregnancy, reaching its nadir in the third trimester and rapidly returning to prepregnancy levels after delivery. The symptoms of diabetic DKA in pregnancy are no different from those seen in women who are not pregnant, except that they tend to develop more rapidly in pregnancy.
