The patient is a 28- year- old female with insulin- dependent diabetes. She developed viral gastroenteritis with nausea and vomiting. She did not take her insulin and she became increasingly nonresponsive. Her husband called 911 and she was taken to the emergency room. Her pulse rate was 128 and her respiratory rate was 28, deep, and smelled fruity (Kussmaul breathing). Her urinary glucose and ketone levels were both 4+. Her pH was dangerously low. Explain how the body attempted to compensate for the low serum pH.
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