Diabetic Ketoacidosis
A medical emergency in which absolute or severe relative insulin deficiency unleashes unopposed lipolysis and ketogenesis alongside unrestrained hyperglycaemia, producing a life-threatening triad of hyperglycaemia, ketonaemia and acidosis that fluids, insulin and potassium replacement are designed to reverse in that order.
First principles
DKA is what happens when insulin deficiency removes the brake on two pathways at once
Without enough insulin, the liver ramps up glucose production (glycogenolysis and gluconeogenesis) while tissues cannot take glucose up, so glucose climbs steeply. Simultaneously, insulin's suppression of lipolysis is lost, so fat breaks down into free fatty acids that the liver converts into ketone bodies (acetoacetate and beta-hydroxybutyrate) as an alternative fuel. Both pathways run unchecked for the same reason (too little insulin), which is why hyperglycaemia and ketosis appear together rather than as separate problems.
Educational content pending clinical review. Not medical advice.