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Type 2 diabetes with metabolic decompensation — CCFP MCQ

Instant feedback + full explanation. One question, done properly.

HardChronic disease managementType 2 diabetes with metabolic decompensationCCFP

A 48-year-old with newly diagnosed type 2 diabetes has polyuria, weight loss, ketonuria and marked hyperglycemia. Which presentation requires immediate insulin rather than routine oral-monotherapy initiation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — New diabetes with weight loss, ketonuria, and marked hyperglycemia

Explanation lettering: E = shown as A · A = shown as C · C = shown as D · D = shown as E

A is correct. Metabolic decompensation or severe symptomatic hyperglycemia requires immediate insulin, with or without metformin. B, C, D and E are distinct conditions. Assess for ketoacidosis and urgent hospital needs.

Reference: Diabetes Canada: Pharmacologic glycemic management—2024 update: https://guidelines.diabetes.ca/cpg/chapter-13-2024-update