A 22-year-old female with Acetest 40 mg/dL and urine glucose 500 mg/dL presents for evaluation. Which interpretation best matches these results?

• A. Your lab results pattern suggests diabetes mellitus.
• B. You probably have been crash dieting recently.
• C. The two results do not fit any disease pattern.
• D. The tests need to be repeated because they could not possibly occur together.

Answer: (A)

Glycosuria together with ketonuria indicates insulin deficiency driving both high blood glucose and fat breakdown. The urine glucose result shows significant hyperglycemia, and the Acetest detecting ketones confirms ketosis. In a young patient, this combination is most consistent with diabetes mellitus, where insufficient insulin allows glucose to spill into urine and promotes ketone formation. While diabetic ketoacidosis is a concern when ketosis is present, the urine pattern alone supports a diabetes mellitus interpretation; additional blood tests would be needed to evaluate for DKA (acid-base status, bicarbonate, anion gap) if clinically indicated.