DIABETES MELLITUS-COMPLICATION MONITORING

SUMMARY

1. Patients need annual evaluations for microvascular complications.

2. Do a urine spot albumin:creatinine as a test for nephropathy (normal < 30 mg/g). Microalbuminuria is 30-300 mg/g.

3. Check creatinine and estimate GFR.

4. Ophthalmologist for a slit lamp exam/fundus photography and rapidly refer macular edema or proliferative retinopathy.

5. Inspect the feet visually and perform a sensory evaluation using the 10 gm monofilament, pinprick, temperature, and vibration.

6. Loss of two-point discrimination & vibratory sense predicts foot ulcers.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].