Two cases are presented of diabetic ketoacidosis (DKA) occurring in newly presenting gestational diabetes mellitus (GDM) in Nigeria. Both were associated with foetal death, and the cases emphasise the need for efficient GDM screening and patient education. GDM is increasing in frequency, and the 2013 World Health Organization (WHO) Guidelines give simple and applicable guidelines for screening, diagnosis, and management. Even glycosuria testing can be helpful at a primary care level. The reoccurrence of GDM is also high (up to 50% of cases), and such women should be encouraged to seek early antenatal care in subsequent pregnancies.

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