Diabetic ketoacidosis in pregnancy resulting from insulin pump failure. A case report.

Ketoacidosis remains one of the most serious complications that can occur in the pregnant diabetic. A 36-year-old class D diabetic presented at 35 weeks' gestation with signs and symptoms of diabetic ketoacidosis. The etiology of her ketoacidosis was insulin pump malfunction. The normal physiologic changes associated with pregnancy placed the woman at increased risk for the development of ketoacidosis. The development of ketoacidosis is a well-known complication of insulin administered via pregnancy. We recommend that the insulin pump be used in selected patients in whom close surveillance can be maintained.