<prompt> An obese patient presented in casualty in an unconscious state. His blood sugar measured 400 mg, urine tested positive for sugar and ketones; drug most useful in management is:GlibenclamideTroglitazoneInsulinChlorpropamide  <response>: Answer is C Insulin : Diabetic ketoacidosis cannot be reveed without insulin - Harrison The patient in the above question is a definite case of diabetic Ketoacidosis, as suggested by increased blood sugar Diabetes and presence of sugar ketones in urine ketoacidosis in an obese type I diabetic. Diabetic ketoacidosis cannot be reveed without insulin Remember: Apa from diabetes the only other common ketoacidotic state is alcoholic ketoacidosis. Alcoholic ketoacidosis is invariably associated with hypoglycemia. A plasma glucose estimation usually is required to delineate such patients. Most patients have a plasma glucose, levels of less than 150 mgdl. Hyperglycemia may occur but is usually mild, rarely if ever exceeds 300 mgdl. It is impoant to know this distinction as, in contrast to diabetic acidosis this syndrome is rapidly reversed by the intravenous administration of glucose. 