Which statement best describes diabetic ketoacidosis (DKA) in pregnancy compared with the non-pregnant state?
- A It occurs only when plasma glucose exceeds 400 mg/dL
- B It can develop at plasma glucose levels as low as 200 mg/dL ✓
- C Ketogenesis is suppressed by placental hormones
- D Bicarbonate therapy is indicated once pH falls below 7.2
Correct answer: B. It can develop at plasma glucose levels as low as 200 mg/dL
Explanation
Pregnancy is a ketogenic state driven by placental hormones, accelerated starvation, and reduced buffering capacity, so DKA develops faster and at lower glucose values, occasionally around 200 mg/dL. Waiting for glucose above 400 mg/dL delays diagnosis and endangers the fetus, since fetal loss rates reach significant levels during maternal DKA. Ketogenesis is enhanced, not suppressed, in pregnancy. Bicarbonate is reserved for pH below approximately 6.9, not 7.2.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.