You are meeting with your pt who has T2DM and is 26 weeks pregnant. She reports that her fasting and post-prandial bg values have been within target range and that she is taking insulin before each meal as advised. However, she also reports that almost everyday of the last two weeks, she has had a small to moderate amount of ketones present in her urinE. Of the options, which management plan would best address this problem?
A. As long as ketones are not consistently larger and her bg values are within range, there is no need to adjust her regimen
B. The pt's bedtime long acting insulin dose should be increased to eliminate the ketones
C. Since ketones are the byproduct of the breakdown of fat, the pt should increase the amount of fat eaten throughout the day so that she will gain wt instead of lose it
D. The pt should add a substantial snack at bedtime, coupled with a dose of prandial insulin to cover the snack