DKA pathophysiology. i will simplify it so you will understand it better.

kena faham. its a state of severe insulin deficiency, or bankruptcy. mcm type 1 dm, xde cell yg boleh hasilkan insulin. pt depend on sc insulin

insulin ni secara mudah fungsi dia utk tarik glucose masuk dalam cell. cell needs glucose utk hasilkan 32 atp for various purpose to keep on living.

now bayangkan x ada insulin. can the glucose enter the cell?
No. so glucose will accumulate in the circulation.

Now dlm cell xde glucose.
this is the state that we call “cellular starvation”
The cute cell igt oh, xde glucose eh? mesti dlm blood vessel xde glucose... cell igt macam tu! when in reality its the exact opposite

so ape cell buat? dia mengadu kat hypothalamus. hypothalamus detect this “cellular starvation” state. hypothalamus pun ape dia buat? it fire all catabolic hormones mcm catecholamine, glucagon, costisol n growth hormones.

all these hormones fungsi dia utk increasekan glucose.
bagaimana?
1. glycogenolysis
2. gluconeogenesis
3. lipolysis

glycogenolysis ni baik. santun orgnya. ada 200g je dlm badan. dia kata xpa ambiklah buat glucose.

next glycogen habis, badan kita start gluconeogenesis. penghasilan glucose baru from non-glucose source mcm protein n fat.

so protein pun undergo krebs cycle yada yada terhasillah glucose. makin bnyk glucose dlm darah. (pulak dah!). pastu, done dengan proteolysis, badan kita proceed dgn lipolysis. all for the sake of increasing glucose.

the problem start here
-FREAKIN LIPOLYSIS-

lipolysis ni from triglyceride to FFA pergi ke liver undergo krebs cycle yada yada end up with ketones

ketone ni adik2, abang2 kakak2.. dia boleh bagi energy jgk. nk utilize dia kena ada insulin. masalahny sekarang. insulin tak ada! so this patient cannot utilize ketone. ketone ni pulak accumulate in the body n worsen acidosis pulak.

now, glucose dlm circulation bertambah2. glucose best friend is water. dia tarik water from the cell into the circulation.

lepastu, glucose threshold kat kidney pulak dh lebih, keluar pulak glucose in the urine. dia tarik sape? yes water! thats why la DKA patient often dpt hypovolemic shock. becoz of this la

harap faham lah ye. dont ask question. XD