Diabetes

Question 1

What are the common examination findings?

Answer 1

This depends on the system you have been asked to examine:

Opthalmology - Signs of Diabetic retinopathy

• Mild pre - microaneurysms
• Moderate Pre - Splinter haemorrhags, exudates
• Severe Pre - Dot and blot haemorrhages, cotton wool spots
• Proliferative - Neovascularization

Peripheral vascular - Signs of a diabetic foot or lack of pulses

Charcot foot, ischaemia, toe loss, neuropathic ulcers,

Neurology - Peripheral neuropathy, particularly pain and vibration

Question 2

What are the investigations?

Answer 2

By the bed - History, obs, and exam systems that could be affected eg, neuro, PAD, Opthalmology

Bloods - FBC for infection and to rule out other causes, U/E for renal function, LFTS for other causes, GLUCOSE and HBA1C to test,

Risk factors - Cholesterol

Urine - For Glucose and renal function

Question 3

What is the treatment?

Answer 3

Conservative - Explain what diabetes is, explain how lifestyle has a big impact (weight loss, diet etc).

Talk about MDT team and regular check ups for eyes, feet/dietician etc

Medical - Protocol for DM management eg metformin, gliclazide

Surgical - Amputaiton if poor peripheral circulation

Question 4

What are the risk factors?

Answer 4

Obesity

Smoking

Alcohol

Family History