Ketoacidosis occurs with the deficiency of which hormone?

• A. Growth hormone
• B. Glucagon
• C. Cortisol
• D. Insulin

Answer: (D)

Ketoacidosis happens when insulin is deficient because insulin normally keeps ketone production in check. Without enough insulin, the liver switches to producing ketone bodies from fatty acids released during unrestrained lipolysis. These ketones—acetoacetate and beta-hydroxybutyrate—accumulate and create an anion-gap metabolic acidosis, a hallmark of diabetic ketoacidosis seen in people with type 1 diabetes or during times of insulin shortage. Other hormones like glucagon, cortisol, and growth hormone promote glucose production and lipolysis, worsening the situation, but the fundamental trigger is the lack of insulin.