Which clinical indicator should the nurse identify as expected for a client with type 2 diabetes?

Which clinical indicator should the nurse identify as expected for a client with type 2 diabetes?

• A. Hyperglycemia and urine negative for ketones
• B. Ketones in the blood but not in the urine
• C. Glucose in the urine but not hyperglycemia
• D. Blood and urine positive for both glucose and ketones

Answer: (A)

In type 2 diabetes you typically see elevated blood glucose due to insulin resistance, but there is usually enough insulin to prevent significant fat breakdown into ketones. That means hyperglycemia with no ketones in the urine is the expected pattern. Ketone production occurs when insulin is severely deficient, as in diabetic ketoacidosis, which is more common in type 1. So the best indicator is high blood glucose with a negative urine ketone test. If ketones were present, or if glucose appeared in urine only without hyperglycemia, these would suggest different or more acute metabolic issues. Similarly, finding both glucose and ketones in blood and urine points toward ketoacidosis, not the typical state of stable type 2 diabetes.

In type 2 diabetes you typically see elevated blood glucose due to insulin resistance, but there is usually enough insulin to prevent significant fat breakdown into ketones. That means hyperglycemia with no ketones in the urine is the expected pattern. Ketone production occurs when insulin is severely deficient, as in diabetic ketoacidosis, which is more common in type 1. So the best indicator is high blood glucose with a negative urine ketone test.

If ketones were present, or if glucose appeared in urine only without hyperglycemia, these would suggest different or more acute metabolic issues. Similarly, finding both glucose and ketones in blood and urine points toward ketoacidosis, not the typical state of stable type 2 diabetes.