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Question:

An unresponsive patient with diabetes is brought to the emergency department with slow, deep respirations. Additional findings include: blood glucose 450 mg/dL (24.9 mmol/L), arterial pH 7.2, and urinalysis showing presence of ketones and glucose. Which of the following statements best describes the underlying cause of this patient's presentation?

A Lack of insulin causes increased counter-regulatory hormones and ketone release
explanation

This patient is suffering from diabetic ketoacidosis (DKA) caused by insulin deficiency, which prevents glucose from entering the cells. DKA is life-threatening and requires rapid intervention. Because the cells are not able to receive glucose, the body breaks down fat and muscle for energy. The body releases an counter-regulatory hormones and undergoes lipolysis in an effort to increase glucose, resulting in hyperglycemia, ketogenesis, and acidosis.

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