What is the most common trigger for diabetic ketoacidosis in pregnancy?

What is the most common trigger for diabetic ketoacidosis in pregnancy?

• A. Infection
• B. Missed insulin doses
• C. Hyperemesis
• D. Corticosteroid use

Answer: (A)

In pregnancy, stress from illness is a major trigger for diabetic ketoacidosis because infection drives a surge of stress hormones (like cortisol, adrenaline, and glucagon) that push the body toward glucose production and fat breakdown. The placenta and pregnancy amplify insulin resistance, so even a relatively modest rise in these hormones can tilt metabolism toward ketosis when insulin is insufficient or not used effectively. Dehydration from fever or poor intake during infection further promotes ketone formation, making DKA more likely. Missed insulin doses and hyperemesis can precipitate DKA as well, and corticosteroid use can raise blood glucose, but infection is the most common precipitating factor in pregnant patients with diabetes. When evaluating a pregnant patient with DKA, look closely for an infectious trigger (even subtle signs) and treat the underlying infection promptly alongside correcting the metabolic derangements.

In pregnancy, stress from illness is a major trigger for diabetic ketoacidosis because infection drives a surge of stress hormones (like cortisol, adrenaline, and glucagon) that push the body toward glucose production and fat breakdown. The placenta and pregnancy amplify insulin resistance, so even a relatively modest rise in these hormones can tilt metabolism toward ketosis when insulin is insufficient or not used effectively. Dehydration from fever or poor intake during infection further promotes ketone formation, making DKA more likely.

Missed insulin doses and hyperemesis can precipitate DKA as well, and corticosteroid use can raise blood glucose, but infection is the most common precipitating factor in pregnant patients with diabetes. When evaluating a pregnant patient with DKA, look closely for an infectious trigger (even subtle signs) and treat the underlying infection promptly alongside correcting the metabolic derangements.