Diabetes mellitus type 2 physical examination: Difference between revisions
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{{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]]. | |||
==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> | |||
===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 | [[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 | *[[Pigmented lesions|Pigmented]] pretibial patches is seen in half of diabetic patients and it is associated with microangiopathic complications. | ||
*[[Acanthosis nigricans]] | *[[Acanthosis nigricans]] is suggestive of [[insulin resistance]]. | ||
===HEENT=== | ===HEENT=== | ||
[[Periorbital edema]] is a finding in patients with [[diabetic nephropathy]]. | [[Periorbital edema]] is a finding in patients with [[diabetic nephropathy]]. | ||
===Neck=== | ===Neck=== | ||
[[Carotid bruits]] may be auscultated unilaterally using the bell of the stethoscope is a sign | [[Carotid bruits]] may be auscultated unilaterally using the bell of the stethoscope, it is a sign suggestive of [[atherosclerosis]]. | ||
===Lungs=== | ===Lungs=== | ||
Normal [[auscultation]]. | Normal [[auscultation]]. | ||
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Signs of [[pretibial myxedema]] or [[ankle edema]] are findings in late diabetes. | Signs of [[pretibial myxedema]] or [[ankle edema]] are findings in late diabetes. | ||
===Neuromuscular=== | ===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. | *Bilateral [[sensory loss]] in the upper and lower extremities may develop as [[neuropathy]] progresses. | ||
==References== | ==References== | ||
Revision as of 14:29, 4 April 2017
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Diabetes mellitus type 2 Microchapters |
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Differentiating Diabetes Mellitus Type 2 from other Diseases |
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Diagnosis |
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Treatment |
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Medical therapy |
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
Patients with diabetes mellitus type 2 usually have normal physical examination findings unless complications develop in these patients.[1]
Appearance of the patient
Patients are usually well-appearing.
Vital signs
High blood pressure with normal pulse pressure may be seen.
Skin
- Pigmented pretibial patches is seen in half of diabetic patients and it is associated with microangiopathic complications.
- Acanthosis nigricans is suggestive of insulin resistance.
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
- ↑ Inzucchi SE (2012). "Clinical practice. Diagnosis of diabetes". N. Engl. J. Med. 367 (6): 542–50. doi:10.1056/NEJMcp1103643. PMID 22873534.