— 生理適應 · EASY · MCQ —
一位第一型糖尿病病人血糖 450 mg/dL。下列哪項發現暗示病人正發展為糖尿病酮酸中毒（DKA）？
A client with type 1 diabetes mellitus presents with a blood glucose level of 450 mg/dL. Which finding indicates the development of diabetic ketoacidosis (DKA)?
- AIncreased urine output尿量增加
- BIncreased insulin sensitivity胰島素敏感性增加
- CPresence of ketones in the urine✓ 正解尿液中存在酮體
- DHypotension and tachycardia低血壓與心搏過速
— Explanation · 中文詳解 —
DKA 的病理生理學在於胰島素缺乏導致脂肪分解產生酮體。雖然高血糖、脫水（心跳快、尿量多）也是 DKA 特徵，但「酮尿」是診斷 DKA 的特異性指標，用於區分單純高血糖狀態。B 選項錯誤，DKA 時身體呈現高度胰島素阻抗狀態。
The presence of ketones in the urine is a specific indicator of diabetic ketoacidosis (DKA), resulting from fat breakdown due to insulin deficiency. While polyuria and tachycardia occur in hyperglycemia, ketonuria distinguishes DKA from other states of elevated blood glucose.
✦ 台美臨床差異
美台醫療體系對於 DKA 診斷均高度依賴血糖與血中酮體濃度，美國急診常用即時床邊檢測。