A 19-Year-Old Female with Type 1 DM Was Admitted to the Hospital

A 19-year-old female with type 1 DM was admitted to the hospital with altered consciousness and the following lab values: serum glucose 500 mg/dl (high) and serum K⁺ 2 (low) .Her parents state that she has been sick with the "flu" for a week.The diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS) .What relationship do these values have with her insulin deficiency?

A) Increased glucose utilization causes the shift of fluid from the intravascular to the intracellular space.
B) Decreased insulin causes hyperglycemia and osmotic diuresis.
C) Increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte loss.
D) Increased insulin use results in protein catabolism, tissue wasting, and electrolyte loss.