Diabetic ketoacidosis (DKA) is best described as which of the following?

• A. A metabolic state of excess insulin causing hypoglycemia
• B. An emergency due to insulin deficiency with ketone production and metabolic acidosis
• C. A condition caused by excess glucagon without glucose changes
• D. A mild dehydration without acidosis

Answer: (B)

DKA is driven by insulin deficiency, which removes the signal that allows glucose to enter cells and shifts metabolism toward fat breakdown. This results in increased ketone production by the liver; those ketones accumulate in the blood and create a high anion gap metabolic acidosis. The combination of severe hyperglycemia, dehydration from osmotic diuresis, and electrolyte disturbances makes DKA a medical emergency requiring prompt IV fluids, insulin, and electrolyte management. It is not caused by excess insulin, which would cause hypoglycemia, nor by glucagon alone without glucose changes, and the key feature is the metabolic acidosis with ketones rather than just mild dehydration.