Diabetes

ID

cc: Polyuria & polydipsia

HPI

• Polyuria

  • Onset

  • Progression

  • Alleviating factors

  • Aggravating factors

  • Quantify urinary output

  • Nocturia

• Polydipsia

  • Onset

  • Progression

  • Alleviating factors

  • Aggravating factors

More HPI

• Previous experiences of these symptoms

• History of diabetes

Associated symptoms

• Fatigue

• Weight change

• Visual blurring

• Abdo pain, n/v

• Dehydration

• Recurrent vaginal infections

Diabetes history

• Diagnosis

  • When?

  • How?

• DM education

  • Dietician, diabetes nurse educator

• Medications for DM

  • Oral/injectable/insulin (injection/pump)

    • need help with medications/injections?

  • Compliance

  • Prior treatment (reasons why no longer used?)

• Hospitalizations for DM

  • DKA, HHS

• Self monitoring of blood glc (SMBG)

  • Method

    • glucometer, flash metre, continuous glucose monitor

  • How often?

    • Fasting, before/after meals, before bed

  • Values throughout day? Trends?

  • How often hypoglycemia (<4 mmol/L)?

    • Hypoglycemia awareness

    • Severe hypo (need help, EMS)

    • How treated?

• Complications

  • Macrovascular

    • CAD

    • CVD

    • PAD

  • Microvascular

    • Retinopathy

      • Most recent eye check?

    • Neuropathy

      • numbness/tingling in extremities

      • Early satiety

      • ED

      • Pain in extremities

    • Nephropathy

• Vaccinations

  • Flu

  • Pneumovax

  • Shingles

  • COVID

• Family Hx of DM, GDM

• Driving

  • Check prior to driving?

  • 5 to drive

• Medic alert bracelet

Risk factors

• Age

• Ethnicity (Hispanics, Native Americans, African Americans, Asians/Pacific Islanders)

• Family history

• Obesity (abdo girth)

• Medications (steroids)

• Lifestyle

  • Sedentary lifestyle

  • Diet

• History of GDM, PCOS, HTN

Medications

• Compliance

Allergies

Past Medical history

Habits

• Smoking

• EtOH

• Recreational meds

• Diet

  • frequency of meals / snacks

  • eating out vs eating in (who cooks/shops)

  • Carb intake / Carb counting / glycemic index

• Physical activity level

• Weight trends

Social history

• Work

  • drug plan

• Finances

  • Can afford medications?

FIFE