Durnwald Celeste, Polsky Sarit
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Barbara Davis Center for Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
Diabetes Technol Ther. 2025 Jul 9. doi: 10.1089/dia.2025.0300.
Diabetic ketoacidosis (DKA) occurring during pregnancy is an obstetric emergency that can result in significant adverse outcomes for both the pregnant person and the fetus. While DKA generally presents with glucose levels >250 mg/dL, up to 30% of DKA cases involve euglycemic DKA (euDKA) wherein glucose levels <200 mg/dL have been reported. However, detection and prevention of DKA in pregnancy can be challenging for both the pregnant individual and health care providers due to variable clinical presentations of the disease and the limitations of current ketone monitoring technologies. Abbott Diabetes Care (Alameda, CA) is developing a dual monitoring system that utilizes a single sensor to enable continuous monitoring of interstitial glucose and β-hydroxybutyrate, the primary metabolic product of blood ketones. This article reviews the challenges of monitoring ketones during pregnancy and discusses how continuous ketone monitoring could be considered for use in clinical practice once it becomes commercially available.
妊娠期发生的糖尿病酮症酸中毒（DKA）是一种产科急症，可对孕妇和胎儿造成严重不良后果。虽然DKA通常表现为血糖水平>250mg/dL，但高达30%的DKA病例涉及血糖正常的DKA（euDKA），其中已报告血糖水平<200mg/dL。然而，由于该疾病临床表现的多样性以及当前酮体监测技术的局限性，对孕妇和医疗保健提供者而言，妊娠期DKA的检测和预防都具有挑战性。雅培糖尿病护理公司（加利福尼亚州阿拉米达）正在开发一种双重监测系统，该系统利用单个传感器实现对组织间液葡萄糖和β-羟基丁酸（血液酮体的主要代谢产物）的连续监测。本文综述了妊娠期酮体监测的挑战，并讨论了一旦连续酮体监测商业化可用，如何考虑将其用于临床实践。
