ketosis vs. ketoacidosis

We got let of class early today, right before the instructor was going to explain the physiology of DKA. Reviewing the book and online sources, I can't figure out what makes the difference between dietary ketosis and DKA. I understand the clinical findings, but why does the DKA patient fall into an extreme acidotic state? To see what I'm talking about, check out the clinical profiles.











ketosisketoacidosis
insulin
ketogenesis
ketonemia
ketonuria
pH-
Anion gap-
Lactic acidosis-
glucose
gluconeogenesis
glucosuria-

I dismiss the role of lactic acidosis since, as I understand it, lactic acidosis occurs as an effect rather than cause of DKA.

This leaves two possibilities: (1) relative increased ratio of production to utilization of ketones in DKA (either absolute ratio or ratio of rate); or (2) the pH change is wholly attributable to the dehydration caused by glucosuria in DKA.

I could make a story for either of these, but it's also possible there's some other contributing factor like kidney damage that I'm missing.

Anyone have any insights? Please reply.

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