Pathophysiology of DKA

• Increased Ratio of Counter-regulatory Hormones:

• (Glucagon, GH, Catecholamines, Cortisol) / Insulin

• “Glucose Toxicity” : Acquired Insulin Resistance

• Hyperglycemia:

• Decreased Glucose Utilization

• Increased Glycogen Breakdown

• Increased Gluconeogenesis (Decreased Fructose 2,6 – Biphosphate)

• Dehydration (Osmotic Diureisis)

• Ketosis:

• Mobilization of fatty acids from adipose tissue

• Increased oxidation of fatty acids (Increased CPT I / Decreased Malonyl- CoA)

• to acetoacetate and Β- hydroxybutyrate