For each effect related to glucose metabolism A–E, select the best option for a possible cause from the following list

A. Option 5 Somatostatin. This is one of the effects of somatostatin secreted by the D cells of the islets of Langerhans.

B. Option 4 Insulin. Insulin increases both potassium and glucose uptake by muscle cells. Injections of glucose and insulin are sometimes given to lower potassium levels in blood when they are dangerously high.

C. Option 3 Insulin deficiency. This results from the increased breakdown of protein for gluconeogenesis in insulin deficiency.

D. Option 1 Hypoglycaemia. Glucagon acts to raise blood glucose by glycogenolysis and gluconeogenesis.

E. Option 2 Metabolic acidosis. The increase in ventilation with Kussmaul breathing results from stimulation of the respiratory system by the hydrogen ions liberated from keto-acids formed in severe diabetes.