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}}{{AE}}{{VD}} | <ref>http://spectrum.diabetesjournals.org/content/15/1/28</ref>{{CMG}}{{AE}}{{VD}} | ||
==Overview== | ==Overview== | ||
Patients with classic onset presentation of type 1 DM are usually well appearing. Whereas patients with diabetic ketoscidosis present with tachycardia, tachypnea (kussumal breathing) and dehydration. | Patients with classic onset presentation of type 1 DM are usually well appearing. Whereas patients with diabetic ketoscidosis present with tachycardia, tachypnea (kussumal breathing) and dehydration. | ||
==Physical Examination== | ==Physical Examination== | ||
Physical examination of 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> | Physical examination of 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 | ||
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|Appearance of patient | |Appearance of patient | ||
|Patient is usually well appearing | |Patient is usually well appearing | ||
|Patients are ill appearing, may be confused or in state of coma | |Patients are ill appearing, may be 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 volume | |Pulse rate- [[Tachycardia]] with regular rhythm, weak volume | ||
Temperature- Normal or elevated or hypothermia | Temperature- Normal or elevated or [[hypothermia]] | ||
Blood pressure- Low blood pressure | Blood pressure- Low blood pressure | ||
Respiratory rate- | Respiratory rate- | ||
* Tachypnea | * [[Tachypnea]] | ||
* Kussmal respirations may be present in late presentation | * Kussmal respirations may be present in late presentation | ||
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 glucose level- markedly elevated | ||
|- | |- | ||
|Skin | |[[Skin]] | ||
|Skin examination is usually normal, but in some cases may reveal dry skin | |Skin examination is usually normal, but in some cases may reveal 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 examination is usually normal, in some cases eye examination may reveal opacity of lens(Cataract) | ||
|Dry | |Dry mucous membrane, eyes may appear sunken because of dehydration | ||
|- | |- | ||
|Neck | |Neck | ||
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|Neck examination is normal | |Neck examination is normal | ||
|- | |- | ||
|Lungs | |[[Lungs]] | ||
|Lungs examination is normal | |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 | |Lungs examination is usually normal, but in some cases lung examination may reveal underlying triggering causes of diabetes ketoacidosis eg: [[pneumonia]] | ||
|- | |- | ||
|Heart | |[[Heart]] | ||
|Heart examination is normal | |Heart examination is normal | ||
|Heart examination is usually normal | |Heart examination is usually normal | ||
|- | |- | ||
|Abdomen | |[[Abdomen]] | ||
|Abdominal examination is normal | |Abdominal examination is normal | ||
|Abdominal tenderness may be elicited | |Abdominal tenderness may be elicited | ||
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|Back examination is usually normal | |Back examination is usually normal | ||
|- | |- | ||
|Genitourinary | |[[Genitourinary]] | ||
|Genitourinary examination is usually normal | |Genitourinary examination is usually normal | ||
|Genitourinary examination is usually normal | |Genitourinary examination is usually normal | ||
|- | |- | ||
|Extremities | |[[Extremities]] | ||
|Extremities examination is usually normal, some cases may elicit finding of decreased sensation in the extremities | |Extremities examination is usually normal, some cases may elicit finding of decreased sensation in the extremities | ||
|Extremities examination is usually normal | |Extremities examination is usually normal | ||
|- | |- | ||
|Neuromuscular | |[[Neuromuscular]] | ||
|Neuromuscular examination is usually normal, | |Neuromuscular examination is usually normal, | ||
|Neuromuscular examination is usually normal | |Neuromuscular examination is usually normal |
Revision as of 17:40, 28 December 2016
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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 ketoscidosis present with tachycardia, tachypnea (kussumal 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
- ↑ 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".