A nurse teaches a client with diabetes mellitus who is experiencing numbness and reduced sensation. Which statement should the nurse include in this client's teaching to prevent injury?

Choice A rationale: Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by hyperglycemia (glucose > 250 mg/dL), ketonemia, and metabolic acidosis. It typically occurs in type 1 diabetes when there is an absolute insulin deficiency, leading to increased lipolysis and ketone body production. DKA is not associated with low blood glucose levels.
Choice B rationale: Diabetic neuropathy is a long-term complication of diabetes resulting from sustained hyperglycemia, which damages nerves throughout the body. Symptoms can include pain, numbness, tingling, or muscle weakness. This condition is a chronic effect of poor glucose control and is not an acute state caused by a sudden drop in glucose levels.
Choice C rationale: Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is a serious complication, predominantly in type 2 diabetes, marked by extremely high blood glucose levels (typically > 600 mg/dL), severe dehydration, and hyperosmolarity without significant ketosis. This condition is the opposite of what the client is experiencing, as it involves very high, not low, glucose levels.
Choice D rationale: Hypoglycemia is a condition characterized by abnormally low blood glucose levels, specifically below 70 mg/dL. This occurs when there is an imbalance between insulin action and glucose intake, such as too much insulin, skipped meals, or intense exercise. The brain relies on glucose for energy, and its function is compromised in hypoglycemia, leading to symptoms like confusion, shakiness, and sweating.

Choice A rationale: The abdomen is actually the preferred site for insulin injections due to its consistent and rapid absorption rate compared to other sites. While absorption can vary slightly depending on the specific location within the abdomen, it is considered more predictable than other areas. Avoiding the abdomen would eliminate a prime injection site, which would make proper site rotation more difficult to achieve.
Choice B rationale: Choosing a different site at random for each injection is not the recommended approach. While it ensures rotation, it can make it difficult to monitor for site reactions or track the effectiveness of different injection sites. A systematic rotation strategy is preferred to ensure that all areas are used appropriately and consistently over time, preventing tissue damage.
Choice C rationale: Giving the injection in the same area each time, or even in the same exact spot, is the primary cause of lipohypertrophy and lipoatrophy. Repeated trauma to the same tissue leads to fibrous tissue formation and fat deposition or breakdown, which can significantly alter insulin absorption, making glycemic control unpredictable and increasing the risk of both hypoglycemia and hyperglycemia.
Choice D rationale: Rotating sites within the same anatomical location, such as the abdomen, for approximately one week before moving to a new location (e.g., the thigh or arm), is the recommended practice. This systematic approach ensures that tissue at the injection sites has time to heal, preventing the development of lipodystrophies. It also helps maintain consistent insulin absorption.