Diabetes Complications Examination

Question 1

Describe the aspects of the diabetes complications exam

Answer 1

• Inspection
  
  • Legs and feet
    
    • Ulcers/injuries
    • Sweaty feet?
    • Skin and hair changes
    • Charcot foot/claw foot (contraction of the interphalangeal muscles due to denervation)
  • Muscle wasting
• Palpation
  
  • Pulses (feeling these - 80mmHg perfusion pressure) - Doppler if you’ve got it
  • Cap refill
  • Temperature
• Neurological examination (no sharps)
  
  • Microfilament - MT heads, lateral malleolus, underneath knee
  • Vibration - measure the frequency at which the patient stops feeling it (Rydel-Seiffer). Most people do this at 3 or 4
  • Reflexes
• Opthalmological examination
  
  • Visual acuity
  • Fundoscopy
• Urine dipstick