Diabetic ketoacidosis most commonly occurs in which type of diabetes?

• A. Type 2 diabetes.
• B. Type 1 diabetes.
• C. Prediabetes.
• D. Gestational diabetes.

Answer: (B)

Diabetic ketoacidosis occurs when insulin is too low to allow glucose to enter cells, so the body switches to breaking down fat for fuel and produces ketones, leading to high glucose, dehydration, and metabolic acidosis. This situation is most likely when there is near-complete lack of insulin, which happens in type 1 diabetes due to autoimmune destruction of pancreatic beta cells. Without endogenous insulin, ketogenesis runs unchecked and DKA develops readily, especially during illness or stress.

In type 2 diabetes there is usually enough insulin to suppress significant ketone production, even if blood glucose can become very high, so DKA is far less common. Prediabetes and gestational diabetes involve abnormalities in glucose regulation but do not typically present with the absolute insulin deficiency that drives DKA, making DKA much less likely in those groups.