임신성 당뇨병에 유발된 당뇨병성 케톤산증 1예 (A Case of Diabetic Ketoacidosis in Gestational Diabetes Mellitus)

서지정보

· 발행기관 : 대한당뇨병학회
· 수록지 정보 : Diabetes and Metabolism Journal / 31권 / 4호 / 368 ~ 371페이지
· 저자명 : 김명환, 정의달, 손호상, 이지현, 홍승표, 배규환, 안선영, 전언주, 홍성연

초록

임신성 당뇨병은 임신 중 발견되는 당뇨병으로 국내에서도 1.7~4.0%의 유병률로 보고되고 있고 비교적 흔한 대사성 질환이다. 임신성 당뇨병에서 당뇨병성 케톤산증은 매우 드물게 나타나지만 산모와 태아에게 매우 심각한 합병증을 야기시킬 수 있기 때문에 임신성 당뇨병에 대한 진단 및 치료는 매우 중요하다. 최근에 저자들은 26세, 임신 37주의 산모에서 발생한 당뇨병성 케톤산증을 경험하였다. 임신 28주 이후에 임신성 당뇨병에 대한 진단 및 치료가 제대로 이루어지지 않은 상태에서 유발된 당뇨병성 케톤산증이었지만 적절한 치료로 산모와 태아 모두 케톤산증의 합병증은 초래되지 않았다.

영어초록

Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variant severity with onset or first recognition during present pregnancy. Recently the prevalence of GDM in Korean has reported as 1.7~4.0%. Diabetic ketoacidosis is a serious metabolic complication of diabetes with high mortality if undetected. Its occurrence is very rare in gestational diabetes patients, but is harmful to fetal and maternal health. A 26 years-old pregnant woman was admitted at 37 weeks gestation because of progressive generalized weakness, anorexia and weight loss. Initial physical examination reveals that she had been dehydrated, and blood pressure 130/80 mmHg, pulse rate 100/min, respiratory rate 20/min, and body temperature was 36.9℃. Serum glucose was 545 mg/dL, pH 7.282, HCO3- 10.5 mmol/L, urine ketone 3+, urine glucose 2+ when initial laboratory work was done. She was treated with intravenous fluid and insulin under the impression of diabetic ketoacidosis. Her delivery was performed after 24 hours from admission because of suggestive fetal distress. After recovery, she is being treated with insulin at outpatient department. We experienced a appropriately treated case of diabetic ketoacidosis in pregnant woman with GDM, and report it with a literature review. (J Kor Diabetes Assoc 31:368~371, 2007)

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