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Key points• Diabetic ketoacidosis (DKA) is a medical emergency and bedside capillary ketone testing allows timely diagnosis and identification of successful treatment.These include full blood count, urea, creatinine, potassium, sodium, chloride, CRP, and liver function tests. Fig 1 GlucoMen blood glucose meter Developments in the management of diabetic ketoacidosis in adults

By reading this article you should be able to: Describe the implications of diabetes in pregnancy on mother and baby. Discuss the rationale for recommendations about glycaemic control in labour. Identify the complications associated with the use of a variable rate insulin infusion. Formulate a multidisciplinary plan for the safe intrapartum management of women with diabetes for operative delivery.

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