Registered Nurse (RN) Endocrine Licensure Exam

Which patient population is most at risk for DKA?

1. A. Middle-aged adults who are obese

2. B. Older adults with Type 2 diabetes

3. C. Newly diagnosed diabetes

4. D. None of the options

The correct answer is: C. Newly diagnosed diabetes

The patient population that is most at risk for diabetic ketoacidosis (DKA) is newly diagnosed diabetes. This situation generally applies to individuals who have been recently diagnosed with Type 1 diabetes, as they often present with DKA at the time of diagnosis due to the lack of insulin production. In these cases, the body cannot utilize glucose effectively, leading to the breakdown of fat for energy, which produces ketones and contributes to the development of acidosis. While other groups, such as middle-aged adults who are obese or older adults with Type 2 diabetes, may experience diabetes-related complications, they are statistically less likely to present with DKA compared to those newly diagnosed with Type 1 diabetes. Particularly in Type 2 diabetes, patients typically have some degree of insulin resistance, which can prevent the metabolic derangements seen in DKA until later in the disease process or in the presence of significant stressors like infection, major surgeries, or other exacerbating factors. Therefore, focusing on patients with newly diagnosed diabetes provides clarity on the population primarily at risk for this acute and serious condition.