Question

Diabetes

What does a good physical exam include if I have diabetes?

A Answers (1)

  • A good physical will include a close examination of all the parts of your body, from head to toe.
    • Weight or body mass index.
    • Blood pressure and pulse.
    • Eyes. Make sure to keep your provider abreast of any changes that have occurred, even if you are also seeing an eye care specialist.
    • Heart and lungs. Your provider will most likely listen to your heart and lungs through a stethoscope. Sometimes an electrocardiogram or stress electrocardiogram may be performed.
    • Feet. You will be checked for calluses, infections, and sores. Using a monofilament to check for sensation, your provider will look for any loss of feeling that could indicate neuropathy.
    • Skin. Your skin, your largest organ, will be examined by sight, with special attention to insulin injection sites.
    • Nervous system. Your reflexes and your sensitivity to the sharpness of a monofilament or pin or the light touch of cotton or a brush will be checked. If you are experiencing any persistent problems, such as dizziness on standing, pain, burning sensation, numbness in your legs or arms, constipation, diarrhea, difficulty urinating, or difficulty with erection or sexual satisfaction, mention them.
    • Mouth and neck. Your provider will examine your gums, teeth, mouth, and throat. She or he will feel for swelling in the glands in your neck. The function of your thyroid gland will also be assessed.
    • Blood. A sample of blood will be drawn to test for glucose levels and A1C which may also be reported as estimated average glucose. A fasting lipid profile, which measures cholesterol and triglycerides, will be performed to determine the levels of these fats in your blood. Your urea nitrogen and serum creatinine concentrations in the blood will also be measured to assess your kidney function.
    • Urine. Kidney function is also assessed by testing urine for ketones, glucose, and protein. People with diabetes are more likely to have urinary tract infections because of the high concentrations of glucose in urine and the loss of the sensation of knowing when the bladder is empty or full because of neuropathy.
    • Vaccinations. People with diabetes are more likely to develop complications from the flu or pneumonia. You need a pneumonia vaccine once in your lifetime and a flu shot each year.
    • Other tests. For women, this includes a Pap smear, mammogram, and gynecological and rectal exam. Men should receive prostate and rectal exams. Both sexes should have their stool samples tested for blood to detect colon cancer.
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