New-Onset IDDM Presenting With Diabetic Ketoacidosis in a Pregnant Adolescent

To describe the presentation of insulin-dependent diabetes mellitus(IDDM) as ketoacidosis during pregnancy in a teenager.

A 14-year-old pregnant girl presented with ketoacidosis (bicarbonate 14 nM, 14 meq/l, pH 7.27, glucose 67 mM, 1,208 mg/dl) during the last month of pregnancy with a fetal demise. Two years of follow-up has confirmed that she has IDDM.

Diabetes presenting in pregnant adolescents is likely due to IDDM. Immediate insulin therapy and proper education about managing diabetes should be initiated to hopefully prevent the outcome described in this patient.