Ketoacidosis is a metabolic state characterized by overproduction and accumulation of ketone bodies (ketoacids), leading to potentially life-threatening drops in blood pH. Common to these disorders is a reduction in the insulin-glucagon ratio signaling a lack of available cellular fuel. This change promotes lipolysis and subsequent hepatic β-oxidation of fatty acids, yielding acetyl-CoA that is converted into ketone bodies (acetoacetate, β-hydroxybutyrate, and acetone). Additionally, increased levels of other counterregulatory hormones (eg, catecholamines, cortisol, and growth hormone) often play a key role in exacerbating ketogenesis and the catabolic state.