A nurse explains the cause of diabetic ketoacidosis in diabetes. Which of the following best describes the primary metabolic process?

• A. Breakdown of fat stores for energy
• B. Ingestion of too many highly acidic foods
• C. Excessive secretion of endogenous insulin
• D. Increased amounts of cholesterol

Answer: (A)

When insulin is deficient or not used effectively, glucose can’t enter cells, so the body turns to fat for energy. This triggers breakdown of fat stores (lipolysis), releasing fatty acids that the liver converts into ketone bodies. The accumulation of these ketones in the blood causes metabolic acidosis, which is the hallmark of diabetic ketoacidosis. So the primary metabolic process is the breakdown of fat stores for energy leading to ketone production. Ingestion of acidic foods, excessive endogenous insulin, or increased cholesterol aren’t the driving processes behind DKA.