Which condition typically does NOT present with ketone bodies in the urine?

In the context of diabetic emergencies, hyperglycemic hyperosmolar state (HHS) is typically characterized by high blood glucose levels, extreme dehydration, and altered consciousness, but it does not usually lead to the production of ketone bodies in the urine. HHS generally occurs in individuals with type 2 diabetes and is primarily driven by the lack of insulin, leading to a severe lack of glucose utilization without significant ketosis.

In contrast, diabetic ketoacidosis (DKA) is marked by high blood glucose levels along with the development of ketone bodies due to the lack of insulin, primarily seen in type 1 diabetes. Type 1 diabetes typically results in the production of ketones when insulin is insufficient. Furthermore, while some cases of type 2 diabetes can produce ketones, it is not as prominent in HHS cases due to the residual insulin activity that is usually present. Thus, the distinction lies in the metabolic processes occurring during these conditions, where HHS typically does not lead to ketone production.