What is diabetic ketoacidosis (DKA)?

• A. A mild illness with occasional high blood sugar.
• B. A serious condition characterized by hyperglycemia, dehydration, electrolyte loss, and metabolic acidosis.
• C. A chronic complication of type 2 diabetes.
• D. A condition caused by low blood sugar.

Answer: (B)

Diabetic ketoacidosis is a life-threatening emergency in which insufficient insulin leads to very high血 glucose, dehydration from osmotic diuresis, and a loss of electrolytes, all accompanied by metabolic acidosis from accumulation of ketone bodies. When insulin is deficient, glucose stays in the blood and cells can’t use it for energy, prompting the body to break down fats. The fat breakdown produces ketones, which build up and lower the blood pH, causing acidosis. The high glucose pulls water into the urine, causing dehydration and further electrolyte losses, including potassium, bicarbonate, and phosphate. This combination—severe hyperglycemia, dehydration, electrolyte disturbance, and metabolic acidosis with ketones—defines DKA.

Clinically, you’d see symptoms like extreme thirst and urination, nausea or vomiting, abdominal pain, fast and deep breathing (Kussmaul respirations), rapid heartbeat, and sometimes a fruity breath. Lab findings typically show blood glucose often above 250 mg/dL, anion-gap metabolic acidosis with low bicarbonate, positive ketones in blood or urine, and signs of electrolyte imbalance. DKA requires urgent management with intravenous fluids, careful electrolyte replacement (especially potassium), and insulin therapy to correct hyperglycemia and acidosis, while addressing any precipitating trigger such as infection or missed insulin. It’s not a mild illness, not a chronic complication, and it isn’t caused by low blood sugar.