Question

Assertion (A): In uncontrolled diabetes mellitus, patients are prone to lactic acidosis and ketoacidosis. Reason (R): In such patients, the kidneys cannot excrete lactic acid and ketoacids due to dehydration.

• A. Both A and R are individually true and R is the correct explanation of A
• B. Both A and R are individually true but R is NOT the correct explanation of A
• C. A is true but R is false
• D. A is false but R is true

Hint:

Ask whether these acids build up mainly because of extra production, or because of reduced excretion.

Answer 1

The Correct Option is B

Step 1: Understanding the Question:
The question tests whether uncontrolled diabetes really predisposes to lactic acidosis and ketoacidosis, and whether reduced renal excretion caused by dehydration is the correct reason for that.

Step 2: Key Concept or Approach:
In uncontrolled diabetes, insulin lack drives unchecked lipolysis and hepatic ketogenesis, producing ketoacids, while volume depletion and poor tissue perfusion push cells toward anaerobic metabolism, producing lactate. The dominant mechanism behind both acidoses is increased production of these acids, not a failure to excrete them, though dehydration does reduce renal clearance to a smaller degree.

Step 3: Working Through the Options:
A is true, uncontrolled diabetics are indeed prone to both lactic acidosis and ketoacidosis. R is also true taken on its own, since dehydration does reduce the kidneys' ability to clear these acids. However, R is not the correct explanation of A, because the acids build up mainly from increased production due to insulin deficiency and tissue hypoperfusion, not primarily because the kidneys fail to excrete them.

Step 4: Conclusion:
Both statements are true individually, but R does not correctly explain A, which matches the option stating both are true and R is not the correct explanation of A.