Patients with type I diabetes often require insulin injections. Which of the following situations would most require an insulin injection?
(A) After eating a stalk of celery
(B) After eating a cookie
(C) After skipping breakfast
(D) After drinking a lot of water

Diabetes mellitus is a disease characterized by an inability of the cells to properly produce (type I) or respond (type II) to insulin, a hormone produced by the pancreas in response to high levels of blood glucose. Without insulin, glucose accumulates in the blood. In situations of low blood glucose, another pancreatic enzyme, glucagon, is released, which triggers the process of gluconeogenesis, shown on the right side of the pathway below. The stimulators, activators, or inhibitors of each step are shown with + or - signs.

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GLYCOLYSIS F-2,6-BP + AMP Θ ATP Citrate H Θ F-1,6-BP + ATP Alanine Phosphofructo- kinase Glucose Fructose 6-phosphate Pyruvate kinase Fructose 1,6-bisphosphate Several steps Fructose 1,6-bisphosphatase Phosphoenolpyruvate GLUCONEOGENESIS Phosphoenol- pyruvate carboxykinase Pyruvate Pyruvate carboxylase ⒸF-2,6-BP AMP + Citrate ⒸADP Oxaloacetate + Acetyl-COA ⒸADP