Patient/caregiver were instructed on the causes and risk factors for development of diabetic ketoacidosis as follows:

Diabetic ketoacidosis is a life-threatening complication of diabetes, arising out of acute insulin lack or deficiency.

So, any of the below conditions that compromise insulin intake or action can potentially contribute to development of diabetic ketoacidosis. Also, conditions that acutely increase insulin requirements can also contribute to development of diabetic ketoacidosis.

• Noncompliance with insulin intake or recommended dose of insulin intake can result in acute hyperglycemic states, altered body metabolism, increased fat breakdown, and presentation with ketosis.
• Malfunctioning insulin pump can deliver inadequate insulin dose and thereby, increase the risk for presentation with acute hyperglycemia and ketosis.

• Noncompliance with dietary requirements can result in exposure to higher doses of insulin, development of insulin resistance, frequently changing insulin requirements, acute hyperglycemic states, and risk for ketosis.
• Presentation of stressful states, such as, acute illness, infection, or physical and emotional distress, can increase release of stress hormones – adrenaline and cortisol. These hormones acutely alter the body metabolism, cause sharp spike in blood sugar levels, and consequently increase the insulin requirement. Failing to keep up with this acutely changed insulin requirement puts one at risk for presentation with diabetic ketoacidosis. Also, these stressful states can impair intake of nutrition, furthering the difficulty to manage safe blood sugar levels.
• Acute inflammatory states, such as, pancreatitis, can impair normal insulin secretory responses and contribute to acute hyperglycemic states, altered body metabolism, increased fat breakdown, and presentation with ketosis.