Diabetes mellitus type 1 physical examination

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[1]Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]

Overview

Patients with classic onset presentation of type 1 DM are usually well appearing. Whereas patients with diabetic ketoacidosis present with tachycardia, tachypnea (Kussmaul breathing) and dehydration.

Physical Examination

Physical examination of type 1 DM include:[2][3][4][5]

Examination findings Classic new onset Diabetic ketoacidosis
Appearance of patient Patient is usually well appearing Patients are ill appearing, may be confused or in state of coma
Vital Signs Pulse rate- Normal

Temperature- Normal

Blood pressure- Normal

Respiratory rate- Normal

Oxygen saturation- Normal

Blood glucose level- Elevated

Pulse rate- Tachycardia with regular rhythm, weak volume

Temperature- Normal or elevated or hypothermia

Blood pressure- Low blood pressure

Respiratory rate-

Oxygen saturation- usually normal but some cases may have low oxygen saturation.

Blood glucose level- markedly elevated

Skin Skin examination is usually normal, but in some cases may reveal dry skin Poor skin turgor because of dehydration
HEENT HEENT examination is usually normal, in some cases eye examination may reveal opacity of lens. (Cataract) Dry mucous membrane, eyes may appear sunken because of dehydration
Neck Neck examination is normal Neck examination is normal
Lungs Lungs examination is normal Lungs examination is usually normal, but in some cases lung examination may reveal underlying triggering causes of diabetes ketoacidosis (eg, pneumonia)
Heart Heart examination is normal Heart examination is usually normal
Abdomen Abdominal examination is normal Abdominal tenderness may be elicited
Back Back examination is normal Back examination is usually normal
Genitourinary Genitourinary examination is usually normal Genitourinary examination is usually normal
Extremities Extremities examination is usually normal, some cases may elicit finding of decreased sensation in the extremities Extremities examination is usually normal
Neuromuscular Neuromuscular examination is usually normal, Neuromuscular examination is usually normal

References

  1. http://spectrum.diabetesjournals.org/content/15/1/28
  2. http://www.aafp.org/afp/2005/0501/p1705.pdf
  3. Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016
  4. http://spectrum.diabetesjournals.org/content/15/1/28
  5. "ADA".

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