A person with type 1 diabetes ran out of her prescription insulin and has not been able to inject insulin for the past 3 days. An overproduction of which of the following could cause a metabolic acidosis?
Ketone bodies are weak acids. In diabetic ketoacidosis, the liver produces ketone bodies, which will reduce the brain's dependency on glucose as its sole energy source. This is due to the lack of insulin and the liver switching to starvation mode owing to the constant signaling by glucagon. Hb in the red blood cells and bicarbonate, both in the red blood cells and the plasma, are two of the body's major buffers, and their overproduction would not lead to an acidosis. HCl overproduction within the stomach might lead to duodenal ulcers or gastroesophageal reflux, but not to an overall metabolic acidosis, because the protons do not find their way into the circulation. A loss of chloride, if severe enough, could produce a metabolic alkalosis, but not an acidosis.
Hb
Ketone bodies
HCl
Bicarbonate
Miscellaneous (Bio-Chemistry)