Why is ketosis rare in clients with type 2 diabetes, even when blood glucose levels are very high (higher than 900 mg/dL)?
A. Ketosis is less prevalent among obese adults.
B. People with type 2 diabetes have normal lipid metabolism.
C. There is enough insulin produced by type 2 diabetes to prevent fat catabolism but not enough to prevent hyperglycemia.
D. Oral antidiabetic agents do not promote the breakdown of fat for fuel (lipolysis), and exogenous insulin spares carbohydrates at the expense of fats.
C
Ketosis occurs as a result of fat catabolism when intracellular glucose is unavailable for energy production. The client with type 1 diabetes becomes ketotic because he or she produces no insu-lin and blood glucose cannot enter the cells. In type 2 diabetes, natural insulin production con-tinues, although at a greatly reduced level. This level is not sufficient to keep blood glucose levels in the normal range but permits just enough glucose to enter cells for energy production so that fats are not catabolized for this purpose.
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