Diabetes Mellitus USMLE Step 1 Practice Question
A 72 year old man with type 2 diabetes is brought for confusion after several days of poor water intake and urinary frequency. Glucose is 920 mg/dL, serum osmolality is markedly elevated, pH is 7.36, and ketones are minimal. Which of the following best explains why significant ketoacidosis is absent?
Answer choices
- AHyperkalemia suppresses glucagon release
- BExcess calcitonin blocks lipolysis
- CResidual insulin activity suppresses lipolysisCorrect answer
- DRenal bicarbonate wasting prevents ketone formation
- ETSH directly stimulates glucose uptake
- FIncreased adiponectin levels enhance fatty acid oxidation to glucose rather than ketones
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