INS and diabetic ketoacidosis: As insulin deficiency progresses, the liver produces alternate fuels, the ketones, that do not require insulin for entry into cells but are acidic leading to potentially deadly diabetic ketoacidosis (DKA)Diabetic ketoacidosis: (DKA) is a serious complication of diabetes that develops when there is insufficient insulin produced (through destruction of beta cells) and fat is used for fuel, with a subsequent accumulation of ketones, causing the blood to become acidic and leading to toxicity in all tissues (including brain, heart, muscle) of the body.