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Gestatianal diabetes mellitus (GDM) is defined as glucose intolerance of variable severity with onset or first recognition during present pregnancy, is associated with adverse pregnancy outcome such as macrosomia, birth trauma, and metabolic complications of newborn. Although most women with GDM have a normal glucose tolerance at postpartum, impairment of insulin secretory capacity and/or increased insulin resistance has been reported in these women, and a substantial proportion of women with GDM will eventually develop NIDDM. Recently the prevalence of GDM in Korean has been reparted as 2-3.6%, which is not different fiom that in white women published in North America. IDDM (type 1 diabetes mellitus) may also be newly acquired during pregnancy. It has been suggested that latent IDDM is presented as GDM during pregnancy, althaugh there are limited reports in Europe and North America. However, there is no case of new-onset IDDM presenting with diabetes ketoacidosis during pregnancy in Korean women. A 36-year-old woman, gravida 1, para 0, was admitted at 37 weeks gestation because of sudden-onset, lower abdominal pain. Her 1-h plasma glucose was 5.5 mmol/L after 50 g oral glucose challenge at 26 weeks gestation. Initial physical and ultrasonographic examination reveals that she had an iintra-uterine fetal death. Seum glucose was 25.1 mmol/L (453 mg/dL), sodium 139 mEq/L, potassium 5.8 mEq/L, chloride 112 mEq/L, bicarbonate 4.1 mEq/L, and arterial blood pH 7.19 when initial laboratory evaluation was done, She was treated with insulin and intravenous fluid under the impression of diabetic ketoacidosis (DKA). After recovery t'rom the DKA, fasting serum C-peptide concentrationa was 0.09 nmol/L (0.27 ng/mL) and HbAlc was 5.8%. Insulin therapy has been needed for glycemic control. We experienced a case of new-onset IDDM presenting with DKA in a pregnant woman and report it with a literature review.