Managing diabetic ketoacidosis in pregnancy

Gómez-Ríos, Manuel Ángel; Gómez-Ríos, D.; Paech, Michael J.; Diéguez-Fernández, M.

doi:10.4103/1658-354x.168829

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…ere will be pupil fixation, breathing with rotten apple odor, and nausea and vomiting symptoms [18][19][20]. If the patient has ketoacidosis, the risk of intrauterine death, neonatal asphyxia, and hyperbilirubinemia will occur, which will seriously affect the normal growth and development of the fetus [21]. In addition, gestational diabetes mellitus complicated with ketoacidosis can cause fetal congenital malformation, intrauterine distress, etc.…”

Section: Discussionmentioning

confidence: 99%

Effect of Continuous Subcutaneous Injection of Insulin Analogues in Pregnant Women with Diabetes Mellitus Complicated with Ketoacidosis

Pan

Wang

Zhao

et al. 2021

Journal of Healthcare Engineering

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Objective. To investigate the clinical effect of continuous subcutaneous injection of insulin analogues in pregnant women with diabetes mellitus complicated with ketoacidosis. Methods. A total of 92 pregnant patients with diabetes mellitus complicated with ketoacidosis from June 2014 to January 2021 were selected. All patients were randomly divided into an observation group and control group according to the method of random number. The control group received intravenous infusion of insulin, and the observation group received continuous subcutaneous infusion of quick-acting insulin analogues. The clinical effects of the two groups were observed. Results. The time needed to control blood glucose <13.8 mmol/L, the amount of insulin needed to control blood glucose <13.8 mmol/L, the time needed to correct DKA, and the amount of insulin needed to correct DKA in the observation group were significantly less than those in the control group ( P < 0.05 ). Compared with the control group, the average occurrence times of hypoglycemia, the length of stay, the total amount of insulin in hospital, and the total amount of insulin used during pregnancy in the observation group were significantly less than those in the control group ( P < 0.05 ). The values of SCr, CRP, BUN, arterial blood gas pH, and adiponectin in the two groups were significantly improved as compared with those before treatment, and the improvement in the observation group was significantly better than that in the control group ( P < 0.05 ). After treatment, the fasting blood glucose, 2-hour postprandial blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin in the experimental group were significantly better than those in the routine group, and the difference was statistically significant ( P < 0.05 ). Conclusion. Continuous subcutaneous injection of insulin analogues is effective in the treatment of diabetic patients with ketoacidosis, which can effectively improve blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin and accelerate the negative conversion of urinary ketone body. It is worth popularizing to reduce the occurrence of hypoglycemia and the dose of insulin and shorten the time of hospitalization.

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Section: Discussionmentioning

confidence: 99%

Effect of Continuous Subcutaneous Injection of Insulin Analogues in Pregnant Women with Diabetes Mellitus Complicated with Ketoacidosis

Pan

Wang

Zhao

et al. 2021

Journal of Healthcare Engineering

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“…3 Case reports have generally shown resolution of fetal heart tracing abnormalities and biophysical profile within 24 hours of treatment initiation, but improvements may be seen as early as 4 hours. [24][25][26] Decision for cesarean delivery, especially in very preterm infants, should be delayed until resolution of maternal DKA if possible. However, if the fetal status remains nonreassuring despite aggressive resuscitation of the patient, delivery should not be delayed.…”

Section: The Fetus As the Second Patientmentioning

confidence: 99%

“…Because of this, fetal heart tracing abnormalities generally improve as the DKA resolves and delivery is rarely indicated 3. Case reports have generally shown resolution of fetal heart tracing abnormalities and biophysical profile within 24 hours of treatment initiation, but improvements may be seen as early as 4 hours 24–26. Decision for cesarean delivery, especially in very preterm infants, should be delayed until resolution of maternal DKA if possible.…”

Section: The Fetus As the Second Patientmentioning

confidence: 99%

Management of Diabetic Ketoacidosis in Pregnancy

Spencer

Clark

Harirah

2022

Clinical Obstetrics &Amp; Gynecology

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Diabetic ketoacidosis (DKA) is a rare, but potentially life-threatening complication of diabetes. Certain physiological changes during pregnancy predispose pregnant individuals to developing DKA. Early recognition and aggressive treatment are essential to avoid maternal and fetal morbidity and mortality. Although laboratory values can help to support, pregnant patients with DKA may not meet the usual criteria and the diagnosis can be made clinically. The key components to treatment include volume replacement, insulin infusion, correction of serum potassium, and fetal monitoring. With appropriate treatment, maternal mortality is low. After recovery, steps should be taken to avoid recurrence.

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