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ASSESSMENT OF

A DIABETIC
PATIENT
Dr. Lee Wai Khew
Pakar Perubatan Keluarga
Klinik Kesihatan Luyang
21.01.2008

Assessment of a new patient


Annual assessment
Repeat visit

Assessment of a
new patient

Step 1
Confirm the
diagnosis

Step 2
Targeted History
taking

Symptoms of diabetes mellitus


Symptoms of complications of
diabetes
Other cardiovascular risk factors
Family history
Life-style history : food intake
exercise
smoking

Step 3
Targeted Physical
examination

General condition
Blood pressure, pulse rate
Weight, height (for BMI)
Waist circumference
Cardiovascular system -?signs of heart
failure
Abdomen central obesity
Foot sensation, pressure sores, deformity,
peripheral pulses
Eyes vision test, funduscopy

Step 4
Appropriate
investigations

Blood sugar random sugar, fasting


sugar
HbA1c
Se Electrolytes and creatinine
Fasting lipid profile
Urine microalbumin / urine FEME
ECG
Hb

Step 5
Assessment of
acceptance of
diagnosis &
management

Step 6
Assessment of
patients
understanding of
the diabetes
mellitus

Step 7
Assessment of
family support

Repeat visit

Patients understanding of the disease


Patients acceptance of treatment
Adherence to treatment
lifestyle modification
medications
Any adverse effects of medications
Any problems encountered with
lifestyle modification

Relevant physical examination


Blood pressure, pulse rate
Weight
Blood sugar examination

Annual assessment

Similar to assessment of new patient


and repeat visit

Thank you