Which term describes a medical emergency characterized by severe hyperglycemia and ketoacidosis in diabetes?

• A. Nonketotic coma
• B. Hypoglycemic coma
• C. Hyperosmolar hyperglycemic state
• D. Diabetic ketoacidosis

Answer: (D)

Diabetic ketoacidosis is a medical emergency defined by severe hyperglycemia accompanied by ketosis and metabolic acidosis due to insulin deficiency. When insulin is lacking, glucose cannot enter cells, the liver releases more glucose, and fat breakdown increases, producing ketone bodies that lower blood pH. This combination causes dehydration, rapid breathing (often a sign of acidosis), tachycardia, abdominal pain, and nausea or vomiting. Prompt treatment is essential and includes fluids, electrolyte management, and insulin therapy.

This differs from the hyperosmolar state, which involves very high glucose and dehydration with little or no ketosis and occurs more often in older individuals with type 2 diabetes. Hypoglycemic coma results from too-low blood glucose, not high glucose with ketones. The term nonketotic coma is an older phrasing for the hyperosmolar state. The presence of ketosis and acidosis is the hallmark that points to diabetic ketoacidosis.