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Diabetic Patient Interview

Decent Essays

Diabetes, a chronic disease, affects all systems within the body. Therefore a thorough, comprehensive exam and patient interview, provides insight for the provider to order required diagnostic testing, assess for comorbidities associated with diabetes, establish diagnosis and develop the plan of care. The aim of this paper will provide step by step recommendations to complete a comprehensive physical exam and patient interview of the diabetic patient.
Often providers may feel overwhelmed in conducting a head to toe physical exam for patients diagnosed with diabetes. Without doubt, the potential for associated comorbidities add to this burden during the physical exam. In consideration for the exam itself, providers may find it useful to focus …show more content…

Specifically inquire about exercise for type, frequency and duration and any complaints of physical limitation for exercise. Equally important, perform a visual inspection of the foot and shoes, coupled with an inquiry as to history of neuropathy or its symptoms, and presence or history of foot ulcerations. As a result, this portion of the exam offers an opportunity for education regarding proper foot care and type of shoes suitable for the diabetic patient. Of great concern, neuropathy development is directly linked to glycemic control and presents as the leading cause for disability due to foot ulceration, amputation gait disturbances and fall related injuries in diabetic patients (Juster-Switlyk, & Smith, 2016). ADA 2017 standards require completion of a comprehensive foot examination and inspection, to include palpation of dorsalis pedis and posterior tibial pulses, assessment for the presence/absence of patellar and Achilles reflexes and determination of proprioception, vibration, and monofilament …show more content…

Pointing out the multiple team approach for diabetes care which may include referrals and future testing dependent upon findings. Examples of possible referral and future testing includes: education referral to certified diabetes educator for comprehensive diabetes education, with focus centered on the impact of diabetes and glycemic control upon the development of comorbidities and multiple body systems. Referral may consist of podiatry/orthopedic/neurology/surgical intervention in the event of peripheral neuropathy and associated complications. Most importantly emphasizing the impact of glycemic control as a primary prevention in the development of micro and macro vascular comorbidities which affect the entire body systems and the overall health of the patient. Referral for comprehensive dental exam, dilated eye exam and dietitian for medical nutrition therapy education and mental health as needed (ADA, 2017). Referral for family planning needs with females considering pregnancy who have not met glycemic control should for extensive education and initiation of self-glucose monitoring. Of importance, in the event of pregnancy, oral agents deemed teratogenic must be stopped and replaced with insulin therapy (Childs, Cypress, & Spollet,

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