Dating a man with type 1 diabetes
Determination of the type of diabetes is based on history, therapy, and clinical judgment.
The chronic complications of diabetes are related to the length of time the patient has had the disease.
Orthostatic vital signs may be useful in assessing volume status and in suggesting the presence of an autonomic neuropathy.
Measurement of the pulse is important, in that relative tachycardia is a typical finding in autonomic neuropathy, often preceding the development of orthostatic hypotension.
Weight loss may not occur if treatment is initiated promptly after the onset of the disease.
Gastrointestinal (GI) symptoms of type 1 DM are as follows: Neuropathy affects up to 50% of patients with type 1 DM, but symptomatic neuropathy is typically a late development, developing after many years of chronic prolonged hyperglycemia.
Ask about the type of insulin being used, delivery system (pump vs injections), dose, and frequency. Of course, a full review of all medications and over-the-counter supplements being taken is crucial in the assessment of patients with type 1 DM.
It is important to inquire about the type and duration of the patient’s diabetes and about the care the patient is receiving for diabetes.If the respiratory rate and pattern suggest Kussmaul respiration, DKA must be considered immediately, and appropriate tests must be ordered.
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