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Since Insulin is unable to act on cells due to insulin resistance, then shouldn't ketoacidosis also occur in Type 2 ?

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Actually, ketoacidosis could occur also in Type 2 Diabetes. It's not common, but it's a possibility and should not be not omitted.

In Type 2 Diabetes the insulin secretion is available but insufficient to meet the glucose needs. However, generally, can prevent sustained hyperglycemic states that could lead to ketoacidosis.

When DKA occurs in patients with type 2 diabetes, the presumed mechanism of ketoacidosis is the combination of relative insulin deficiency and increased secretion of glucagon (as well as other counteregulatory hormones such as cortisol, catecholamines, and growth hormone) in response to stress from 1) overwhelming infection, 2) infarction of tissue, or 3) other severe illness. The elevated catecholamines further suppress insulin secretion to perpetuate a downward spiral. The increased glucagons-to-insulin ratio causes a mismatch that promotes unregulated lipolysis and proteolysis with subsequent uninterrupted formation of ketoacids.

Source

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    What a great source! Thanks. (I also did a bit of editing and included a quote. Please let me know - or roll back - if you object. I changed rare to uncommon because the source cites a study wherein about 20% of admissions for DKA were of patients with T2D. A recent study evaluating 138 consecutive admissions for DKA at a large academic center observed that 21.7% had type 2 diabetes.6 Nearly 70% of the admissions involved discontinuation of medications, and almost half had an identifiable infection when an intensive search was undertaken. – anongoodnurse Feb 14 at 2:52
  • It's a good edit, thanks! – Hichame Yessou Feb 14 at 9:56

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