Diabetic ketoacidosis (DKA) is most common in which type of diabetes?

• A. Type 1 diabetes
• B. Type 2 diabetes
• C. Gestational diabetes
• D. Prediabetes

Answer: (A)

DKA happens when there is not enough insulin to prevent the body from breaking down fat into ketones, leading to ketosis and metabolic acidosis. This scenario is most common in Type 1 diabetes, where autoimmune destruction of pancreatic beta cells causes little or no endogenous insulin. Without insulin, counter-regulatory hormones drive glucose production and fat breakdown aggressively, resulting in hyperglycemia and ketone buildup.

In Type 2 diabetes, some insulin is usually present, so significant ketone production is less common; DKA can happen but is far less typical, usually only with severe illness or when beta-cell function declines markedly. Gestational diabetes and prediabetes involve different metabolic contexts and are not commonly associated with DKA.