Question | Insulin is a kind of hormone which is produced from pancreas inside the human body.

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Question & Answer
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QUESTION & ANSWER1
Question 1
Insulin is a kind of hormone which is produced from pancreas inside the human body. It
enables the body to utilize the sugar or the glucose from the macromolecule carbohydrate present
inside the food that is digested to stockpile energy or glucose for future purpose. Insulin is an
essential component which can maintain the blood sugar level from increasing too much leading
to hyperglycemia or decreasing too such a level that may lead to hypoglycemia (Freund, Logan,
Watson & Wassouf, 2019).
DKA or Diabetic ketoacidosis is a very critical health issue that impacts the health of
people who have diabetes. DKA occurs when the human body starts breaking down the fat in the
pace, which is too fast than the average pace. During this process, the liver transforms the fat into
a fuel known as ketones that decreases the pH level of blood, making it acidic. The most
significant underlying defect in the development of DKA is dehydration which occurs when
there is a deficiency of insulin as a result of a loss of pancreatic tissue which is responsible for
generating insulin (Freund, Logan, Watson & Wassouf, 2019).
Question 2
The reason for Mrs S experiencing DKA because the day before her admission in the
hospital, she did not eat properly and forgot to take the regular insulin dose. Since she had a
history of type I diabetes mellitus since the last 12 years, Insulin is an essential treatment to
prevent the symptoms of diabetes from occurring.
Generally, during the presence of Insulin in the body, it metabolizes glucose. However,
during the absence, it causes the body to digest triglycerides and amino acids. As a result of few

QUESTION & ANSWER2
uncontrolled lipolysis, it lead the glycerol and free fatty acids serum level to increase. Glycerol
and alanine deliver substrate for hepatic gluconeogenesis that gets stirred by the additional
glucagon which accompanies deficiency of Insulin. Glucagon can also enable mitochondrial
conversion of free fatty acids into ketones. Generally, Insulin restricts ketogenesis by restricting
the passage of free fatty acid byproducts into the mitochondrial matrix; however, ketogenesis
continues during the deficiency of Insulin. Acetone generating through the breakdown of
acetoacetic acid gathers in serum and is gradually eliminated by the respiratory process (Cohen,
Zlotzover, Daoud & Shehadeh, 2016).
Because of insulin deficiency, hyperglycemia leads to an osmotic diuresis that causes
marked urinary losses of water and electrolytes. Urinary excretion of ketones enables further
waste of sodium and potassium salts. Serum sodium might decrease as a result of natriuresis or
may increase as a result of excretion of large volumes of free water. Sometimes, there is also a
loss of Potassium in large quantities. Even after a loss of potassium salts, the level of initial
serum potassium is generally average or higher than normal range due to migration of potassium
ions outside the cells because of acidosis (Cohen, Zlotzover, Daoud & Shehadeh, 2016).
Question 3
The main signs and symptoms caused by the Diabetic ketoacidosis (DKA) are extreme
thirst, rise in blood sugar level, nausea, frequent urination, abdominal pain, fatigue and many
more. As the case study suggests, Mrs S had fatigue, and that is why she was not able to stand
correctly and had vomited twice (Morrison & Magann, 2017).
When the level of Ketone keeps rising in the blood, ketones keeps on get passed in the
urine along with which the sodium and potassium salts are being passed out from the body. This