Diabetes mellitus type 2 physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
m (Bot: Removing from Primary care)
No edit summary
Line 3: Line 3:
{{CMG}};{{AE}}{{MehdiP}}
{{CMG}};{{AE}}{{MehdiP}}
==Overview==
==Overview==
Patients with diabetes mellitus type 2 often have normal physical examination findings unless complications develop in these patients. Common physical examination findings include pigmented skin patches and [[acanthosis nigricans]].
Patients with [[diabetes mellitus type 2]] often have normal physical examination findings unless [[Complication (medicine)|complications]] develop in these patients. Common physical examination findings include pigmented skin patches and [[acanthosis nigricans]].
==Physical examination==
==Physical examination==
Patients with diabetes mellitus type 2 usually have normal physical examination findings unless complications develop in these patients.<ref name="pmid22873534">{{cite journal |vauthors=Inzucchi SE |title=Clinical practice. Diagnosis of diabetes |journal=N. Engl. J. Med. |volume=367 |issue=6 |pages=542–50 |year=2012 |pmid=22873534 |doi=10.1056/NEJMcp1103643 |url=}}</ref>
 
* Patients with [[diabetes mellitus type 2]] usually have normal physical examination findings unless [[Complication (medicine)|complications]] develop in these patients.<ref name="pmid22873534">{{cite journal |vauthors=Inzucchi SE |title=Clinical practice. Diagnosis of diabetes |journal=N. Engl. J. Med. |volume=367 |issue=6 |pages=542–50 |year=2012 |pmid=22873534 |doi=10.1056/NEJMcp1103643 |url=}}</ref>
===Appearance of the patient===
===Appearance of the patient===
Patients are usually well-appearing.
Patients are usually well-appearing.
===Vital signs===
===Vital signs===
[[Hypertension|High blood pressure]] with normal pulse pressure may be seen.
 
* [[Hypertension|High blood pressure]] with normal [[pulse pressure]] may be seen.
===Skin===
===Skin===
*[[Pigmented lesions|Pigmented]] pretibial patches is seen in half of diabetic patients and it is associated with microangiopathic complications.
*[[Acanthosis nigricans]] is suggestive of [[insulin resistance]].
*[[Acanthosis nigricans]] is suggestive of [[insulin resistance]].
*Diabetic dermopathy (DD), one of the skin findings of [[diabetes mellitus]], appears as dull red [[Papule|papules]] which cause bilateral involvements on bony prominences. Nevertheless, involvement of pretibial region is the most common presentation, described as [[Pigmented lesions|pigmented]] pretibial patches.<ref name="pmid294659263">{{cite journal| author=Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A | display-authors=etal| title=Endotext | journal= | year= 2000 | volume=  | issue=  | pages=  | pmid=29465926 | doi= | pmc= | url= }}</ref>
[[File:Diabetic Dermopathy.jpg|alt=Diabetic Dermopathy (DD)|center|thumb|530x530px|Diabetic Dermopathy (DD)<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/books/NBK481900/|title=Skin Manifestations of Diabetes Mellitus case courtesy by Jordan Rosen, BS|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref> which is appeared as pretibial patches]]
<br />
*Skin thickening has been frequently seen on feet and hands. Skin appears waxy and [[Edema|edematous]].<ref name="pmid294659262">{{cite journal| author=Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A | display-authors=etal| title=Endotext | journal= | year= 2000 | volume=  | issue=  | pages=  | pmid=29465926 | doi= | pmc= | url= }}</ref>
*[[Necrobiosis lipoidica]] ([[Necrobiosis lipoidica|NL]]): Although, it is usually found after the time of [[diagnosis]], still 14% to 24% of cases of [[Necrobiosis lipoidica|NL]] may occur before or at the time of [[diagnosis]].<ref name="pmid29465926">{{cite journal| author=Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A | display-authors=etal| title=Endotext | journal= | year= 2000 | volume=  | issue=  | pages=  | pmid=29465926 | doi= | pmc= | url= }}</ref>
[[File:Necrobiosis lipoidica (NL).jpg|center|thumb|573x573px|[[Necrobiosis lipoidica]] ([[Necrobiosis lipoidica|NL]]) <ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/books/NBK481900/|title=Skin Manifestations of Diabetes Mellitus case courtesy by Jordan Rosen, BS|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]
===HEENT===
===HEENT===
[[Periorbital edema]] is a finding in patients with [[diabetic nephropathy]].
[[Periorbital edema]] is a finding in patients with [[diabetic nephropathy]].

Revision as of 16:02, 6 August 2020

Diabetes mellitus main page

Diabetes mellitus type 2 Microchapters

Home

Patient information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Diabetes Mellitus Type 2 from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical therapy

Life Style Modification
Pharmacotherapy
Glycemic Control

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Patients with diabetes mellitus type 2 often have normal physical examination findings unless complications develop in these patients. Common physical examination findings include pigmented skin patches and acanthosis nigricans.

Physical examination

Appearance of the patient

Patients are usually well-appearing.

Vital signs

Skin

Diabetic Dermopathy (DD)
Diabetic Dermopathy (DD)[3] which is appeared as pretibial patches


Necrobiosis lipoidica (NL) [6]


HEENT

Periorbital edema is a finding in patients with diabetic nephropathy.

Neck

Carotid bruits may be auscultated unilaterally using the bell of the stethoscope, it is a sign suggestive of atherosclerosis.

Lungs

Normal auscultation.

Heart

Normal findings unless complications occur which may lead to heart failure with preserved EF (HFpEF).

Abdomen

Normal physical examination findings.

Extremities

Signs of pretibial myxedema or ankle edema are findings in late diabetes.

Neuromuscular

  • The patient is usually oriented in person, place, and time.
  • Bilateral sensory loss in the upper and lower extremities may develop as neuropathy progresses.

References

  1. ↑ Inzucchi SE (2012). "Clinical practice. Diagnosis of diabetes". N. Engl. J. Med. 367 (6): 542–50. doi:10.1056/NEJMcp1103643. PMID 22873534.
  2. ↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A; et al. (2000). "Endotext". PMID 29465926.
  3. ↑ "Skin Manifestations of Diabetes Mellitus case courtesy by Jordan Rosen, BS".
  4. ↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A; et al. (2000). "Endotext". PMID 29465926.
  5. ↑ Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A; et al. (2000). "Endotext". PMID 29465926.
  6. ↑ "Skin Manifestations of Diabetes Mellitus case courtesy by Jordan Rosen, BS".
Retrieved from "https://www.wikidoc.org/index.php?title=Diabetes_mellitus_type_2_physical_examination&oldid=1648075"