What is the Difference Between Diabetic Ketoacidosis and Starvation Ketoacidosis?

Diabetic ketoacidosis (DKA) and starvation ketoacidosis (SKA) are both types of ketoacidosis, a high anion gap metabolic acidosis due to an excessive blood concentration of ketone bodies. However, they have different causes and distinct features:

Diabetic Ketoacidosis (DKA):

Occurs in individuals with diabetes mellitus, usually type 1.
Caused by an absolute or relative lack of insulin, leading to diabetic metabolic decompensation.
Characterized by high blood glucose levels, presence of ketones in urine, and a high anion gap metabolic acidosis.
Typically presents with a precipitating factor such as infection or stress, which causes an excess of stress hormones that antagonize the actions of insulin.

Starvation Ketoacidosis (SKA):

Occurs in individuals who are not diabetic and have been deprived of glucose as their primary source of energy for a prolonged time.
Caused by a lack of insulin due to prolonged starvation, leading to increased lipolysis and fatty acid delivery to the liver, which exceeds the capacity of ketogenesis.
Characterized by high levels of glucose-elevating hormones such as glucagon, depleted glycogen stores, and production of ketones for fuel.
May be more easily reversed by the administration of glucose and insulin.

In summary, the main differences between diabetic ketoacidosis and starvation ketoacidosis are their causes (insulin deficiency in diabetes versus prolonged starvation) and the presence of glucose-elevating hormones in starvation ketoacidosis. Treatment for diabetic ketoacidosis usually involves administration of insulin, while starvation ketoacidosis can be treated with glucose administration, and insulin may be added if required.

On this page

What is the Difference Between Diabetic Ketoacidosis and Starvation Ketoacidosis?

Comparative Table: Diabetic Ketoacidosis vs Starvation Ketoacidosis

Here is a table comparing diabetic ketoacidosis (DKA) and starvation ketoacidosis:

Feature	Diabetic Ketoacidosis (DKA)	Starvation Ketoacidosis
Cause	Lack of insulin, leading to high blood sugar levels	Prolonged fasting, depriving the body of glucose as a primary energy source
Triggers	Illness, insulin therapy problems, physical or emotional trauma, heart attack, pancreatitis, pregnancy, alcohol or drug abuse, certain medications like corticosteroids	Economic factors, eating disorders, provinces, and intercurrent illness
Pathophysiology	Occurs as a consequence of absolute or relative insulin deficiency, leading to enhanced hepatic gluconeogenesis, glycogenolysis, and lipolysis	The body breaks down fatty acids to use for energy, causing fatty acids to replace glucose as the major metabolic fuel
Treatment	Rehydration, correction of acidosis, and treatment of underlying cause	Rehydration, correction of acidosis, and addressing the cause of starvation

In summary, DKA is due to a lack of insulin that directs blood sugars into cells, while starvation ketoacidosis is due to prolonged fasting.

Guilherme Mazui

Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.