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From Provo, Utah, USA:

I am 27 years old, have had type 1 diabetes for 16 years, and I am about 26 weeks pregnant with my third child. My blood sugar control is excellent (about 6.0% hemoglobin A1c), I had no complications with the previous pregnancies and am showing no complications again. I have also not seen any complications related to retinopathy, nephropathy, or neuropathy yet.

However, I periodically check for ketones in my morning urine,with my last pregnancy I started showing ketones (moderate to large) at about this time, and I am showing them again now. Since my blood sugars were in such good control, we determined the ketones were due to starvation ketosis and solved the problem by my eating a small snack in the middle of the night. If the ketones are due to starvation ketosis, how dangerous is this (isn't this a normal side-effect to the break-down of fat)? What are the possible side effects to me and to the fetus? Is it necessary to get up for a "midnight" snack to avoid the ketones?


As long as your blood sugar is in good control, the ketones in your urine should not be a problem and will not have an adverse effect on the fetus. This is a fairly common finding in pregnancy, but obviously of concern in the presence of diabetes.

I frequently recommend a bedtime snack for pregnant women taking insulin more to prevent early morning hypoglycemia. In your case, it may prevent the starvation ketosis.


Original posting 14 Jan 2003
Posted to Family Planning


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Last Updated: Tuesday April 06, 2010 15:09:42
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