Diabetes mellitus type 1 physical examination: Difference between revisions
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{{Diabetes mellitus type 1}} | {{Diabetes mellitus type 1}} | ||
{{Diabetes mellitus}} | {{Diabetes mellitus}} | ||
{{CMG}} | <ref>http://spectrum.diabetesjournals.org/content/15/1/28</ref>{{CMG}}{{AE}}{{VD}} | ||
==Overview== | ==Overview== | ||
[[patient|Patients]] with classic onset presentation of [[diabetes mellitus type 1|type 1 DM]] are usually well appearing. Whereas [[patient|patients]] with [[diabetic ketoacidosis]] present with [[tachycardia]], [[tachypnea]] ([[Kussmaul breathing]]) and [[dehydration]]. | |||
==Physical Examination== | ==Physical Examination== | ||
[[Physical examination]] of [[diabetes mellitus type 1|type 1 DM]] include:<ref>http://www.aafp.org/afp/2005/0501/p1705.pdf</ref><ref>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</ref><ref>http://spectrum.diabetesjournals.org/content/15/1/28</ref><ref>{{Cite web|url=http://care.diabetesjournals.org/content/26/suppl_1/s109|title=ADA|last=|first=|date=|website=|publisher=|access-date=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
!Examination findings | !Examination findings | ||
!Classic new onset | !Classic new onset | ||
!Diabetic ketoacidosis | ![[Diabetic ketoacidosis]] | ||
|- | |- | ||
|Appearance of patient | |Appearance of [[patient]] | ||
|Patient is usually well appearing | |[[Patient]] is usually well appearing | ||
| | |[[Patient|Patients]] are ill appearing, may be [[Confusion|confused]] or in state of [[coma]] | ||
|- | |- | ||
|Vital Signs | |[[Vital Signs]] | ||
|Pulse rate- Normal | |[[Pulse rate]]- Normal | ||
Temperature- Normal | [[Temperature]]- Normal | ||
Blood pressure- Normal | [[Blood pressure]]- Normal | ||
Respiratory rate- Normal | [[Respiratory rate]]- Normal | ||
Oxygen saturation- Normal | [[Oxygen saturation]]- Normal | ||
Blood glucose level- Elevated | [[Blood glucose]] level- Elevated | ||
|Pulse rate- Tachycardia with regular rhythm, weak | |[[Pulse|Pulse rate]]- [[Tachycardia]] with regular [[rhythm]], weak volume | ||
Temperature- Normal or elevated | [[Thermoregulation|Temperature]]- Normal or elevated or [[hypothermia]] | ||
Blood pressure- Low blood pressure | [[Blood pressure]]- Low [[blood pressure]] | ||
Respiratory rate- | [[Respiratory rate]]- | ||
* Tachypnea | * [[Tachypnea]] | ||
* | * [[Kussmaul breathing]] may be present in late stages | ||
Oxygen saturation- usually normal but some cases may have low | [[Oxygen saturation]]- usually normal but some cases may have low [[oxygen saturation]]. | ||
Blood glucose level- markedly elevated | [[blood sugar|Blood glucose level]]- markedly elevated | ||
|- | |- | ||
|Skin | |[[Skin]] | ||
|Skin examination is usually normal, but in some cases may reveal | |[[Skin]] [[Physical examination|examination]] is usually normal, but in some cases may reveal [[Xeroderma|dry skin]] | ||
|Poor skin turgor | |Poor [[skin]] turgor because of [[dehydration]] | ||
|- | |- | ||
|HEENT | |HEENT | ||
|HEENT examination is usually normal, in some cases eye examination may reveal opacity of lens(Cataract) | |HEENT [[Physical examination|examination]] is usually normal, in some cases eye [[Physical examination|examination]] may reveal opacity of [[Lens (anatomy)|lens]]. ([[Cataract]]) | ||
|Dry | |Dry [[mucous membrane]], eyes may appear sunken because of [[dehydration]] | ||
|- | |- | ||
|Neck | |[[Neck]] | ||
|Neck examination is normal | |[[Neck]] [[Physical examination|examination]] is normal | ||
| | |[[Neck]] [[Physical examination|examination]] is normal | ||
|- | |- | ||
|Lungs | |[[Lungs]] | ||
|Lungs examination is normal | |[[Lungs]] [[Physical examination|examination]] is normal | ||
|Lungs examination is usually normal, but in some cases lung examination may reveal underlying triggering causes of diabetes ketoacidosis eg | |[[Lungs]] [[Physical examination|examination]] is usually normal, but in some cases [[lung]] [[Physical examination|examination]] may reveal underlying triggering causes of [[diabetes ketoacidosis]] (eg, [[pneumonia]]) | ||
|- | |- | ||
|Heart | |[[Heart]] | ||
|Heart examination is normal | |[[Heart]] [[Physical examination|examination]] is normal | ||
|Heart examination is usually normal | |[[Heart]] [[Physical examination|examination]] is usually normal | ||
|- | |- | ||
|Abdomen | |[[Abdomen]] | ||
|Abdominal examination is normal | |[[Abdominal examination]] is normal | ||
|Abdominal tenderness may be elicited | |Abdominal [[tenderness]] may be elicited | ||
|- | |- | ||
|Back | |Back | ||
|Back examination is normal | |Back [[Physical examination|examination]] is normal | ||
|Back examination is usually normal | |Back [[Physical examination|examination]] is usually normal | ||
|- | |- | ||
|Genitourinary | |[[Genitourinary]] | ||
|Genitourinary examination is usually normal | |Genitourinary [[Physical examination|examination]] is usually normal | ||
|Genitourinary examination is usually normal | |Genitourinary [[Physical examination|examination]] is usually normal | ||
|- | |- | ||
|Extremities | |[[Extremities]] | ||
|Extremities examination is usually normal, some cases may elicit finding of decreased sensation in the extremities | |Extremities [[Physical examination|examination]] is usually normal, some cases may elicit finding of decreased sensation in the extremities | ||
|Extremities examination is usually normal | |Extremities [[Physical examination|examination]] is usually normal | ||
|- | |- | ||
|Neuromuscular | |[[Neuromuscular]] | ||
|Neuromuscular examination is usually normal, | |Neuromuscular [[Physical examination|examination]] is usually normal, | ||
|Neuromuscular examination is usually normal | |Neuromuscular [[Physical examination|examination]] is usually normal | ||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
Latest revision as of 13:03, 20 September 2020
Diabetes mellitus type 1 Microchapters |
Differentiating Diabetes mellitus type 1 from other Diseases |
Diagnosis |
Treatment |
Cardiovascular Disease and Risk Management |
Case Studies |
Diabetes mellitus Main page |
Patient Information |
---|
[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
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
- ↑ http://spectrum.diabetesjournals.org/content/15/1/28
- ↑ http://www.aafp.org/afp/2005/0501/p1705.pdf
- ↑ 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
- ↑ http://spectrum.diabetesjournals.org/content/15/1/28
- ↑ "ADA".