Which statement is true regarding insulin therapy and the risk of diabetic ketoacidosis?

Which statement is true regarding insulin therapy and the risk of diabetic ketoacidosis?

• A. Taking too much insulin increases risk
• B. Not taking enough insulin increases risk
• C. Alcohol reduces risk
• D. Increased insulin always prevents risk

Answer: (B)

The main idea is that diabetic ketoacidosis (DKA) happens when there isn’t enough insulin to meet the body’s needs. When insulin is missing or insufficient, the body can’t use glucose properly and activates fat breakdown to fuel cells. The liver then converts those fats into ketones, causing metabolic acidosis, while osmotic diuresis from high glucose leads to dehydration and electrolyte disturbances. This is why not taking enough insulin—missing doses, poor adherence, insulin pump failure, or illness that raises insulin requirements—greatly increases the risk of DKA. Taking too much insulin tends to cause hypoglycemia, not DKA, so that option isn’t correct. Alcohol doesn’t reduce DKA risk; it can complicate glucose control and doesn’t reliably prevent ketosis. And increasing insulin does not guarantee prevention of DKA because other factors—like infection, dehydration, decreased intake, or pump malfunctions—can still trigger DKA even if some insulin is being used.

The main idea is that diabetic ketoacidosis (DKA) happens when there isn’t enough insulin to meet the body’s needs. When insulin is missing or insufficient, the body can’t use glucose properly and activates fat breakdown to fuel cells. The liver then converts those fats into ketones, causing metabolic acidosis, while osmotic diuresis from high glucose leads to dehydration and electrolyte disturbances. This is why not taking enough insulin—missing doses, poor adherence, insulin pump failure, or illness that raises insulin requirements—greatly increases the risk of DKA.

Taking too much insulin tends to cause hypoglycemia, not DKA, so that option isn’t correct. Alcohol doesn’t reduce DKA risk; it can complicate glucose control and doesn’t reliably prevent ketosis. And increasing insulin does not guarantee prevention of DKA because other factors—like infection, dehydration, decreased intake, or pump malfunctions—can still trigger DKA even if some insulin is being used.