A patient is seeing the nurse practitioner for a 6 months checkup for diabetes mellitus. While reviewing the patient's lab results, which lab best represents the patient has good control of the disease?

A. "Diet, exercise, and oral medications can be effective. I will ask the physician to prescribe Metformin":
Explanation: This statement is not accurate for type 1 diabetes. Type 1 diabetes results from the inability of the pancreas to produce insulin, so oral medications like Metformin, which work to increase insulin sensitivity or reduce glucose production in the liver, are not effective. Insulin replacement is the mainstay of treatment for type 1 diabetes.

B. "Your body does not produce insulin, and the only treatment is injected insulin":
Explanation: This is the correct statement. In type 1 diabetes, the pancreas does not produce insulin or produces very little, and insulin cannot be taken orally because it would be broken down in the digestive system. Therefore, injections are the primary and necessary mode of insulin delivery.

C. "Glucophage can help your body better utilize the insulin secreted by the pancreas":
Explanation: This statement is more applicable to type 2 diabetes, where the pancreas may still produce insulin, but the body's cells are resistant to its effects. In type 1 diabetes, the issue is a lack of insulin production, so medications to improve insulin utilization are not relevant.

D. "Initially, you will need injections, but after your body adjusts to the insulin, you can switch to Metformin":
Explanation: This is not accurate for type 1 diabetes. The need for insulin in type 1 diabetes is not something the body adjusts to over time. Insulin is a lifelong requirement for individuals with type 1 diabetes, and it cannot be replaced by oral medications like Metformin.

A. Development of a buffalo hump and moon face:
This is associated with Cushing's syndrome, a disorder characterized by prolonged exposure to high levels of cortisol.

B. Central obesity and purple striations:
Also indicative of Cushing's syndrome, where excess cortisol can lead to the accumulation of fat in the abdominal area (central obesity) and the development of purple stretch marks (striae).

C. Sudden weight loss without dieting:
This is more characteristic of hyperthyroidism, where the thyroid gland is overactive, leading to increased metabolism and unintended weight loss.

D. Positive Trousseau's sign when checking the client's blood pressure:
Trousseau's sign is associated with hypocalcemia and is seen in conditions affecting the parathyroid gland rather than the thyroid. It involves carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes.