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 the following laboratory values: serum glucose 20 mmol/L (high) , urine glucose and ketones 4+ (high) , and arterial pH 7.20 (low) . Her parents state that she has been sick with the "flu" for a week. Which of the following statements best explains her acidotic state?

A) Increased insulin levels promote protein breakdown and ketone formation.
B) Her uncontrolled diabetes has led to kidney failure.
C) Low serum insulin promotes lipid storage and a corresponding release of ketones.
D) Insulin deficiency promotes lipid metabolism and ketone formation.