A patient has type 1 diabetes (T1DM). The nurse is teaching her the early signs and symptoms of an insulin overdose, which include:

A. Extreme thirst and excessive urination: These are signs of hyperglycemia or diabetic ketoacidosis (DKA), not an insulin overdose. Insulin overdose typically causes hypoglycemia, not elevated blood sugar, which presents differently. B. Abdominal pain and nausea: Abdominal pain and nausea are more commonly associated with diabetic ketoacidosis (DKA) or gastroparesis rather than an insulin overdose. These symptoms are not the typical early signs of hypoglycemia caused by too much insulin. C. Dyspnea, pallor, and ketones in the urine: These are also symptoms associated with DKA, which is a complication of insulin deficiency, not an insulin overdose. In DKA, blood sugar is high, not low, and ketones are present in the urine. D. Perspiration and a trembling sensation: Hypoglycemia (low blood sugar) from an insulin overdose often leads to symptoms like sweating, trembling, shakiness, and dizziness. These are early warning signs that the blood glucose is too low and insulin needs adjustment.