General Examination
·
General built
·
BMI
·
Ketone odour
·
Eyes
o
Corneal arcus
o
Xanthalasma
·
Dry mouth / Mucous membrabes
·
Acanthoosis nigricans
·
Injection sites à
lipohypertrophy, lipoatrophy
·
reduced skin turgor
·
Capillary refill time
·
Diabetic cheiroarthropapthy (stiff hand
syndrome)
·
Carpel tunnel syndrome (Tinel’s sign, Phalen’s
sign, thenar eminence wasting)
·
Granuloma annulare
·
Pustules, abscesses, carbuncle
·
Necrobiosis lipoidica diabeticorum (anterior
shin)
·
Vitiligo
·
Diabetic dermopathy
·
Bullosis diabeticorum (tense blistering on the
feet)
·
Fungal nail infections
·
Deformity
·
Callus
·
Ulcerations
·
Nail care
·
Neuropathic joint à
Charcot neuroarthropathy
Cardiovascular System Examination
·
BP
o
Pulse
§
PR à
tachycardia (dehydration)
§
Peripheral pulses
o
Blood pressure
§
Hypertension
§
Hypotension à
dehydration
§
Postural hpotension
o
Auscultaion
§
Carotid and femoral bruits
Respiratory System Examination
·
Kussmaul breathing
Central Nervous System Examination
·
Eye
o
Reduces pupillary response à diabetic autonomic
neuropathy
o
Visual acuity
o
Funduscopy
§
Cataract à
loss of light reflex
§
Lens for opacities
§
Green light to see microaneurysms
o
Proximal motor neuropathy
§
Diabetic amyotrophy
§
Femoral neuropathy
o
Mononeuropathies
§
Median nerve (Carpel Tunnel Syndrome)
§
Tarsal tunnel syndrome
§
3rd and 6th nerve palsies
o
Autonomic neuropathy
·
Sensation
o
Great toe
o
Metatarsal heads
o
Dorsum
o
Peripheral sensory neuropathy
·
Reflexes
o
Loss of ankle jerk à early diabetic peripheral sensory
neuropathy
