In diabetic emergencies, which condition is characterized by dehydration, hyperglycemia, and ketonuria?

• A. Hypoglycemia
• B. Diabetic ketoacidosis
• C. Hyperglycemic hyperosmolar state
• D. Diabetes insipidus

Answer: (B)

In this scenario, you’re looking for the diabetic emergency that includes dehydration, high blood sugar, and ketones in the urine. That pattern comes from diabetic ketoacidosis, which occurs when there is a severe lack of insulin. Without insulin, glucose stays in the blood and the liver pushes out even more glucose, leading to marked hyperglycemia. The kidneys respond by clearing the excess sugar, which drags water with it, causing dehydration and polyuria. At the same time, the lack of insulin triggers the body to break down fats for energy, producing ketone bodies that spill into the urine (ketonuria) and cause metabolic acidosis.

Hypoglycemia would present with low glucose and energy shortage rather than dehydration with ketones. The hyperglycemic hyperosmolar state involves extremely high glucose and dehydration but little to no ketone production, so ketonuria and acidosis aren’t prominent. Diabetes insipidus features polyuria and thirst without the hyperglycemia or ketone production seen here.