The idea that some people engage in risky behavior due to the fact that they have good health care is known as

Umm im gona keep to myself on that one

You can write out the letter, but it should specify: the patient hasn't been controlling their diabetes bc glucose and ketones spilling into the urine. also, the positive nitrite could indicate a u.t.i. infections can cause hyperglycemia in a diabetic. also the reverse, uncontrolled blood sugar can lead to glycosuria, which is a good nidus for bacteria to grow from sugar in urine, leading to a uti.