A case of newly diagnosed autoimmune diabetes in pregnancy presenting after acute onset of diabetic ketoacidosis

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Perinatal Medicine Pub Date : 2021-01-01 DOI:10.1515/crpm-2020-0042

C. DiNobile, A. Fuchs, K. Herrera

引用次数: 0

Abstract

Abstract Objectives We present a case of immune-mediated diabetes mellitus, diagnosed in pregnancy upon presentation with diabetic ketoacidosis, found to have normal glucose control postpartum. Case presentation A 28-year-old medically uncomplicated G1P0 presented in diabetic ketoacidosis at 28.2 weeks gestation. Workup for pancreatic autoantibodies revealed indeterminate anti-islet cell antibodies and positive anti-glutamic acid antibodies. She was stabilized with intravenous fluids and insulin, and transitioned to long and short acting subcutaneous insulin. Her insulin requirements decreased over the course of her pregnancy. Spontaneous vaginal delivery occurred at 37 weeks. Her postpartum glucose control was normal without re-initiation of insulin. Conclusions The diagnosis of diabetic ketoacidosis during pregnancy should prompt further investigation into an underlying diagnosis of immune mediated diabetes. These patients should be followed closely in the postpartum period.

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妊娠期新诊断自身免疫性糖尿病急性发作后出现糖尿病酮症酸中毒1例

摘要目的我们报告一例免疫介导的糖尿病，在妊娠期间诊断为糖尿病酮症酸中毒，发现产后血糖控制正常。一例28岁医学上无并发症的G1P0于妊娠28.2周出现糖尿病酮症酸中毒。胰腺自身抗体检查显示抗胰岛细胞抗体不确定，抗谷氨酸抗体阳性。她通过静脉输液和胰岛素稳定，并过渡到长效和短效皮下胰岛素。她的胰岛素需求在怀孕期间有所下降。37周时发生自然阴道分娩。产后血糖控制正常，未重新注射胰岛素。结论妊娠期糖尿病酮症酸中毒的诊断应进一步探讨免疫介导型糖尿病的潜在诊断。这些患者在产后应密切随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-

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期刊介绍： Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.