Normoglycemic Diabetic Ketoacidosis in a Pregnant Patient with Type II Diabetes Mellitus Presenting for Emergent Cesarean Delivery

Abstract

The development of acute abdominal pain in a laboring parturient after a previous cesarean delivery is of concern and may be the result of a potentially life-threatening condition such as uterine rupture. We present a case of a parturient with type II diabetes mellitus, who had undergone 2 previous cesarean deliveries and now presented in labor with increasing abdominal pain. An emergency cesarean delivery was performed for probable uterine rupture. Intraoperatively, the patient was noted to be severely hypocarbic with significant metabolic acidosis, and the diagnosis of diabetic ketoacidosis was established.

Euglycemic Diabetic Ketoacidosis in the ICU: 3 Case Reports and Review of Literature

“…The prevalence of ketosis was the same in those who presented glucose peaks greater than 180 mg/dL and those who did not [ 1 ]. It is interesting to observe that, in this study [ 44 ], only 2 patients out of the 60 developed ketoacidosis based on the criteria set forth by the Joint British Diabetes Society [ 45 ] and none of them did, based on the ADA's criteria [ 11 ].…”