What metabolic condition can occur due to insulin deficiency?

• A. Diabetic ketoacidosis (DKA)
• B. Hypoglycemia
• C. Lactic acidosis
• D. Hyperosmolar state

Answer: (A)

Insulin deficiency removes the signal that allows glucose to enter cells and keeps fat breakdown in check. Without enough insulin, the liver and muscles can’t use glucose effectively, so blood sugar rises. At the same time, lack of insulin unleashes fat breakdown, flooding the liver with free fatty acids that are converted into ketone bodies. The accumulation of these ketones creates a high anion-gap metabolic acidosis, and the dehydration from osmotic diuresis due to hyperglycemia compounds the problem. This combination is diabetic ketoacidosis, the classic metabolic complication that follows insulin deficiency, especially in type 1 diabetes or when insulin dosing is forgotten or inadequate. Hypoglycemia would arise from too much insulin relative to glucose, lactic acidosis from other causes like hypoxia or sepsis, and a hyperosmolar state typically involves very high glucose with some insulin present to limit ketosis, not a direct consequence of complete insulin deficiency.