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Ketoacidosis is a life-threatening condition caused by a severe lack of insulin that can occur in type 1 and, less commonly, type 2, diabetes. Blood glucose is high, too little glucose enters cells, and the body breaks down other body tissue, e.g. fat as an energy source. Acidic ketones are produced, and will be detectable in the urine and blood. In pregnancy, ketoacidosis compromises both the fetus and the mother. The majority of cases occur in the second and third trimesters of pregnancy. It tends to occur at lower blood glucose levels and more rapidly than in non-pregnant women, often causing delay in diagnosis. Early detection of ketonuria is essential because ketoacidosis is a factor associated with intrauterine death, and its detection warrants immediate admission for intravenous fluids, insulin and glucose.

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