Fulminant Type 1 Diabetes Developing during Pregnancy in Patient with Gestational Diabetes Mellitus.
10.3904/kjm.2017.92.2.186
- Author:
Jong Ha BAEK
1
;
Kyong Young KIM
;
Soo Kyoung KIM
;
Jung Hwa JUNG
;
Jong Ryeol HAHM
;
Jaehoon JUNG
Author Information
1. Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea. taesikjung@gmail.com
- Publication Type:Case Report
- Keywords:
Diabetes mellitus, Type 1;
Diabetes, Gestational;
Diabetic ketoacidosis
- MeSH:
Acid-Base Equilibrium;
Adult;
Blood Gas Analysis;
Blood Glucose;
Cesarean Section;
Diabetes Mellitus, Type 1;
Diabetes, Gestational*;
Diabetic Ketoacidosis;
Diagnosis;
Dizziness;
Emergencies;
Fasting;
Female;
Fetal Distress;
Gestational Age;
Glucose;
Humans;
Hydrogen-Ion Concentration;
Hyperglycemia;
Insulin;
Ketosis;
Nausea;
Polyuria;
Pregnancy*;
Pregnant Women;
Urinalysis;
Vomiting;
Weight Loss
- From:Korean Journal of Medicine
2017;92(2):186-189
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 32-year-old pregnant woman (34 + 5 weeks) was admitted with dizziness, nausea, and vomiting. Previously, she was diagnosed with gestational diabetes mellitus at 28 weeks with 100 g-OGTT and insulin therapy was started. Her average fasting glucose level was 97 mg/dL and postprandial 1-hour glucose level was 130 mg/dL with basal-bolus insulin therapy (total dose of 28-30 IU/day). At 34 + 0 weeks of gestational age, polyuria and unexpected weight loss (2 kg/week) with hyperglycemia occurred, and total dose of daily insulin requirement was increased up to 50 IU/day. At admission, her serum glucose level was high (502 mg/dL), and urinalysis revealed ketonuria +3. Arterial blood gas analysis revealed pH of 6.83, pCO2 of 9 mmHg, and bicarbonate of 2 mmol/L with an anion gap of 23.5 mmol/L. The diagnosis of diabetic ketoacidosis was established and emergency caesarean section was conducted due to fetal distress. She was finally diagnosed with fulminant type 1 diabetes mellitus, and multiple daily insulin injection therapy was continued after delivery.
