Which factor is commonly associated with precipitating diabetic ketoacidosis (DKA)?

Diabetic ketoacidosis (DKA) is a serious complication that typically arises in individuals with longstanding diabetes, particularly type 1 diabetes, and can also occur in type 2 diabetes under specific conditions. Infection is a significant precipitating factor for DKA due to the physiological stress it creates on the body, which often leads to an increase in insulin resistance, elevated blood glucose levels, and ultimately, a lack of sufficient insulin to counteract ketogenesis.

During an infection, the body’s response includes the release of stress hormones like cortisol and catecholamines, which can further elevate blood glucose levels by stimulating gluconeogenesis and glycogenolysis while also promoting lipolysis. The combination of high glucose and resultant ketosis leads to acidosis, characteristic of DKA. This is why infections are routinely checked for and treated as part of the management of a patient presenting with DKA.

In contrast, factors like increased exercise or improved insulin compliance typically do not precipitate DKA but rather help in the management of diabetes. A low carbohydrate diet can help reduce the incidence of hyperglycemia and prevent ketosis as well. Thus, the association of infection with DKA is well-recognized, underscoring its crucial role as a precipitating factor