Diabetic ketoacidosis occurs when:

• A. It occurs due to dehydration alone.
• B. It occurs when there is ketosis without hyperglycemia.
• C. Insulin is not available in the body.
• D. It occurs when there is hypoglycemia.

Answer: (C)

Diabetic ketoacidosis happens when insulin is not available in the body. Without enough insulin, glucose can’t enter cells to be used for energy, so the body starts breaking down fat for fuel. This fat breakdown produces ketone bodies, which build up and cause metabolic acidosis. The high blood glucose level also leads to dehydration through increased urination, worsening the problem. So the core issue is a lack of insulin that sets off high glucose, ketone production, and acidosis. Dehydration alone doesn’t cause this pattern, ketosis without high glucose isn’t DKA, and hypoglycemia is a low-blood-sugar state, not DKA. In the field, recognize signs like deep, rapid breathing, abdominal pain, vomiting, fruity breath, and signs of dehydration, and manage the patient’s airway and circulation while transport per protocol.