The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse should expect the following symptoms during an assessment, except:
A. Hypoglycemia
B. Frequent bruising
C. Ketonuria
D. Dry mouth
Correct answer: A. Hypoglycemia
Hypoglycemia does not occur in type 2 diabetes unless the patient is on insulin therapy or taking other diabetes medication. In T2DM, the response to insulin is diminished, and this is defined as insulin resistance. During this state, insulin is ineffective and is initially countered by an increase in insulin production to maintain glucose homeostasis, but over time, insulin production decreases, resulting in T2DM.
Option B: Type 2 diabetes can affect blood circulation which makes it easier for the skin to bruise. Decreased blood flow to the area surrounding an injury prevents a wound from healing properly, resulting in the development of bruise-like lesions or spots.
Option C: The presence of ketones in the urine happens due to a lack of available insulin. T1DM patients can often present with ketoacidosis (DKA) coma as the first manifestation in about 30% of patients.
Option D: Losing a lot of fluids caused by frequent urination can lead to dehydration hence patients can develop dry mouth. People with diabetes are prone to dehydration. In those with diabetes, a person’s blood glucose levels can become too high. The term for this is hyperglycemia, and it can cause a person to experience dry mouth.
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