If the diabetic patient has insufficient insulin effect to block the mobilization and metabolism of free fatty acids, the metabolic byproducts acetoacetate and β –hdroxybutyrate accumulate.
|Ketone bodies: 3-hydroxybutyrate, acetoacetate, acetone|
In this case, DKA may be defined as a blood glucose level usually greater than 250 mg/DL, pH less that 7.2 or 7.3 and plasma bicarbonate level of 15 or less. Severe DKA is defined as a pH of 7.1 or less and a bicarbonate level of 10 or less.
The most common precipitating factors in the development of DKA are infection, myocardial infarction, trauma or omission of insulin.