A Comprehensive Review on Management of Euglycemic Diabetic Ketoacidosis (EDKA) in Pregnancy

ABSTRACT Diabetic Ketoacidosis (DKA) is a life-threatening medical emergency. Euglycemic Diabetic Ketoacidosis (EDKA) is a condition that is relatively rare but if missed out can have grave consequences. The primary difference between the two conditions lies in the extent of hyperglycemia in both conditions. In EDKA, the blood glucose levels can be near normoglycemia as well. The clinical features are similar. Good glycemic control in pregnancy is an effective method of preventing complications of EDKA in pregnancy. For EDKA, the glucose levels in blood can be mildly raised; it poses a significant challenge to diagnose EDKA. Therefore, a high index of suspicion is the cornerstone of management of EDKA in pregnancy. The key diagnostic tests are serum electrolytes, arterial blood gas analysis, and ketone level measurements. The treatment includes fluid resuscitation, insulin therapy, acidosis correction, electrolyte monitoring and treating the underlying root cause. Continuous monitoring of both maternal and fetal well-being is crucial throughout treatment. A multidisciplinary and systematic approach to diagnosis and treatment is essential for an optimized outcome. Keyword: Euglycemic DKA, hyperglycemia, diabetic, pregnancy, ketogenesis, acidosis