Which is a common precipitating factor for DKA?

Which is a common precipitating factor for DKA?

• A. Chronic hydration.
• B. Regular daily exercise.
• C. Infection or illness.
• D. Fasting.

Answer: (C)

In DKA, a common trigger is stress from an illness or infection. When the body is fighting an infection, it releases more counter-regulatory hormones such as cortisol, epinephrine, and glucagon. These hormones raise hepatic glucose production and increase insulin resistance, while the person may not be able to take in or absorb enough insulin during illness. The combination of reduced insulin action and higher glucose production causes pronounced hyperglycemia. At the same time, the lack of sufficient insulin shifts metabolism toward fat breakdown, producing ketone bodies that acids accumulate in the blood, leading to the metabolic acidosis characteristic of DKA. Dehydration from the illness and vomiting can worsen this process by reducing renal clearance of glucose and ketones, amplifying the problem. Other factors like chronic hydration, regular exercise, or fasting can influence risk in various ways, but infection or illness is the most common precipitating factor because it robustly triggers the hormonal and metabolic cascade that drives ketogenesis and acidosis in susceptible individuals.

In DKA, a common trigger is stress from an illness or infection. When the body is fighting an infection, it releases more counter-regulatory hormones such as cortisol, epinephrine, and glucagon. These hormones raise hepatic glucose production and increase insulin resistance, while the person may not be able to take in or absorb enough insulin during illness. The combination of reduced insulin action and higher glucose production causes pronounced hyperglycemia. At the same time, the lack of sufficient insulin shifts metabolism toward fat breakdown, producing ketone bodies that acids accumulate in the blood, leading to the metabolic acidosis characteristic of DKA. Dehydration from the illness and vomiting can worsen this process by reducing renal clearance of glucose and ketones, amplifying the problem.

Other factors like chronic hydration, regular exercise, or fasting can influence risk in various ways, but infection or illness is the most common precipitating factor because it robustly triggers the hormonal and metabolic cascade that drives ketogenesis and acidosis in susceptible individuals.