Diabetic ketoacidosis in pregnancy

Crit Care Med. 2005 Oct;33(10 Suppl):S347-53. doi: 10.1097/01.ccm.0000183164.69315.13.


Objective: The development of diabetic ketoacidosis in pregnancy is a medical emergency, requiring treatment in an intensive care setting. Both the mother and the fetus are at risk for significant morbidity and mortality. Physiologic changes unique to pregnancy provide a background for the development of diabetic ketoacidosis. An understanding of these physiologic changes assists in the management of the two patients being treated. Treatment of the patient with diabetic ketoacidosis includes insulin therapy and careful fluid management; recommendations for management are presented.

Patients: Pregnant women, either with preexisting diabetes or with diabetes diagnosed during pregnancy.

Conclusions: Prompt recognition of the clinical manifestations of diabetic ketoacidosis, followed by appropriate, timely treatment will optimize outcome for the pregnant woman and her fetus.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acidosis / etiology
  • Adult
  • Critical Care*
  • Diabetic Ketoacidosis / complications
  • Diabetic Ketoacidosis / physiopathology*
  • Diabetic Ketoacidosis / therapy*
  • Emergencies
  • Female
  • Fetal Death
  • Fetal Diseases / etiology
  • Fluid Therapy
  • Humans
  • Hyperglycemia / etiology
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy in Diabetics / physiopathology*
  • Pregnancy in Diabetics / therapy*


  • Hypoglycemic Agents
  • Insulin