What is diabetic ketoacidosis (DKA)?

• A. A hypoglycemic crisis with low ketones.
• B. A hyperglycemic crisis with metabolic acidosis and elevated serum ketones, primarily occurring in Type I DM.
• C. A hyperglycemic crisis without acidosis.
• D. A hyperosmolar state without ketosis.

Answer: (B)

Diabetic ketoacidosis is a hyperglycemic crisis driven by insulin deficiency and increased counterregulatory hormones, which together cause high blood glucose, rapid ketone production, and metabolic acidosis. The presence of elevated ketones in the blood or urine and a metabolic acidosis (often with an elevated anion gap) are key features. Osmotic diuresis from the high glucose leads to dehydration and electrolyte disturbances, and potassium may appear normal or elevated in the blood even though total body potassium is depleted. This condition most commonly occurs in Type 1 diabetes because of absolute insulin deficiency, though it can occur in Type 2 under stress or illness. So the description of a hyperglycemic crisis with metabolic acidosis and elevated serum ketones best fits DKA. The other scenarios describe hypoglycemia, a hyperglycemic state without acidosis, or a hyperosmolar state without ketosis, which do not match DKA.