Diabetes mellitus type 1 physical examination

^[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– Tachypnea Kussmaul breathing may be present in late stages 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”.

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[1] ttp://spectrum.diabetesjournals.org/content/15/1/28

[2] ttp://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] ttp://spectrum.diabetesjournals.org/content/15/1/28

[5] “ADA”.

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