Pathogenesis and Pathophysiology of Diabetic Ketoacidosis (DKA)


DKA is a result of an absolute or relative insulin deficiency, leading to ketoacidosis, volume depletion and hyperglycemia. Insulin is the primary anabolic hormone that allows peripheral tissues to uptake glucose.  In the absence of insulin, the other counterregulatory hormones act together to break down triglycerides and stimulate gluconeogenesis. In DKA, the normal state of carbohydrate metabolism (driven by insulin) shifts to a starvation state and fat metabolism, leading to the characteristic abnormalities, including hyperglycemia, ketoacidosis, hyponatremia, polyuria, and polydipsia. Please see details of the pathophysiology outlined in the figure/flowchart below.


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