2020 Volume 63 Issue 2 Pages 50-55
We herein report a 31-year-old woman with fulminant type 1 diabetes mellitus associated with pregnancy (PF) who underwent an emergency Caesarean section early at the onset. She had no personal or family history of diabetes, and her blood glucose levels at pregnancy examinations had been normal. At 36 weeks' gestation, she presented with thirst, anorexia, and vomiting and consulted an obstetrician. Because her fetus showed late deceleration, she underwent emergency Caesarean section. The surgery was successful, and the child was cared for in the neonatal intensive-care unit and grew well. However, she suffered chest pain and dyspnea the day after surgery, and hyperventilation, hallucinations, and delusions developed the day after that; therefore, she was transferred to our hospital. Her blood glucose level, urine ketones and arterial blood pH were 676 mg/dL, 4+and 6.948, respectively. She was diagnosed with diabetic ketoacidosis, and her condition improved with immediate transfusion and continuous intravenous insulin infusion. Because her HbA1c was 5.6 %, and anti-GAD antibody and anti-IA-2 antibody were negative with a urinary C-reactive protein value of 0.4 μg/day, she was diagnosed with PF. Recently, several patients with PF have been reported to undergo Caesarean section to save the life of the fetus, so this approach should be considered in such cases.
