Abstract
Pregnancy induces complex changes in energy metabolism, manifested clinically by insulin resistance, low fasting blood glucose levels, and proneness to ketosis. It is quite unusual for pregnant women who do not have type I diabetes to progress from ketosis to frank ketoacidosis, although this phenomenon is common in larger mammals. In the case described here, glucocorticoid administration in the setting of a prolonged fast triggered a metabolic cascade leading to ketoacidosis in a pregnant woman without type 1 diabetes. Other details of this illustrative case serve to synthesize several disparate observations regarding the pathogenesis of pregnancy ketoacidosis. Physicians should be aware of the potential for rapidly developing ketoacidosis with atypical biochemical and clinical features in pregnant women who are treated with high doses of glucocorticoids.
Citations
Apr 14, 2005·Best Practice & Research. Clinical Endocrinology & Metabolism·Lorin Lakasing, Catherine Williamson
May 22, 2010·The British Journal of Nutrition·Clive J Petry
Sep 13, 2002·Acta Obstetricia Et Gynecologica Scandinavica·Elisabeth R MathiesenPeter Damm
Sep 5, 2003·Postgraduate Medical Journal·D KamalakannanT A M Abdu
Apr 8, 2014·World Journal of Gastroenterology : WJG·Giovanni MaconiRoberto de Franchis
Mar 28, 2013·ISRN Obstetrics and Gynecology·Masaki OgawaHideo Matsui
Jul 31, 2012·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Christian RohrmeierRoland Buettner
Jan 27, 2016·Current Diabetes Reports·Paige K BradleyKristin Castorino
Oct 16, 2015·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·M G DalfràA Lapolla
Jun 3, 2011·Diabetes Research and Clinical Practice·Miguel E Pinto, Jaime E Villena
Apr 27, 2007·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·C BarondiotJ-M Hascoet
Oct 26, 2016·Journal de gynécologie, obstétrique et biologie de la reproduction·T Schmitz
Jan 28, 2014·Obstetrics and Gynecology·Baha M Sibai, Oscar A Viteri
Oct 11, 2005·Critical Care Medicine·Mary Anne Carroll, Edward R Yeomans
Dec 1, 2014·Obstetric Medicine·U M GrahamD R McCance
Apr 9, 2020·Emergency Medicine Australasia : EMA·Adam Morton
Dec 25, 2003·Primary Care·Dace L Trence