DVBCWDI1 ;ALB/CMM DIABETES MELLITUS WKS TEXT - 1 ; 5 MARCH 1997
;;2.7;AMIE;**12**;Apr 10, 1995
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;; 1. Age of onset.
;;
;;
;; 2. Frequency of ketoacidosis or hypoglycemic reactions
;; (hospitalization required?).
;;
;;
;; 3. Restricted diet, weight loss or gain since last exam.
;;
;;
;; 4. Describe any restriction of activities.
;;
;;
;; 5. Visual problems.
;;
;;
;; 6. Vascular or cardiac symptoms.
;;
;;
;; 7. Neurologic symptoms.
;;
;;
;; 8. Treatment - oral hypoglycemic, insulin (frequency of injections).
;;
;;
;; 9. Frequency of visits to diabetic care provider.
;;
;;
;; 10. Other symptoms, such as anal pruritus, loss of strength.
;;
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following and fully describe current findings:
;; 1. Blood pressure, other cardiovascular findings, including
;; status of peripheral vessels.
;;
;;
;; 2. Neurologic examination.
;;
;;
;; 3. Eye examination.
;;
;;
;; 4. Skin examination.
;;
;;
;; 5. Examination of extremities, including feet.
;;
;;
;; 6. State if the veteran has bladder or bowel functional impairment.
;; If present, state whether partial or total, intermittent or
;; constant, and what measures are taken as a result of the impairment.
;;
;;
;;D. Diagnostic and Clinical Tests:
;;
;; Provide to establish diagnosis (Previously done test results should
;; be given to establish diagnosis.):
;; 1. Renal function tests, including 24 hour urine test for protein
;; if renal involvement is uncertain.
;; 2. Blood sugar.
;; 3. Urinalysis.
;; 4. Glucose tolerance test, if necessary to establish the diagnosis.
;; 5. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;
;;E. Diagnosis:
;;
;; Comment on:
;; 1. All complications noted - visual, cardiac, vascular, nephrologic,
;; neurologic (including both peripheral neuropathy and cerebral
;; effects), amputations. See examination worksheets for the
;; conditions found.
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWDI1 2487 printed Nov 22, 2024@17:00:25 Page 2
DVBCWDI1 ;ALB/CMM DIABETES MELLITUS WKS TEXT - 1 ; 5 MARCH 1997
+1 ;;2.7;AMIE;**12**;Apr 10, 1995
+2 ;
+3 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;
+4 ;;
+5 ;;B. Medical History (Subjective Complaints):
+6 ;;
+7 ;; Comment on:
+8 ;; 1. Age of onset.
+9 ;;
+10 ;;
+11 ;; 2. Frequency of ketoacidosis or hypoglycemic reactions
+12 ;; (hospitalization required?).
+13 ;;
+14 ;;
+15 ;; 3. Restricted diet, weight loss or gain since last exam.
+16 ;;
+17 ;;
+18 ;; 4. Describe any restriction of activities.
+19 ;;
+20 ;;
+21 ;; 5. Visual problems.
+22 ;;
+23 ;;
+24 ;; 6. Vascular or cardiac symptoms.
+25 ;;
+26 ;;
+27 ;; 7. Neurologic symptoms.
+28 ;;
+29 ;;
+30 ;; 8. Treatment - oral hypoglycemic, insulin (frequency of injections).
+31 ;;
+32 ;;
+33 ;; 9. Frequency of visits to diabetic care provider.
+34 ;;
+35 ;;
+36 ;; 10. Other symptoms, such as anal pruritus, loss of strength.
+37 ;;
+38 ;;
+39 ;;C. Physical Examination (Objective Findings):
+40 ;;
+41 ;; Address each of the following and fully describe current findings:
+42 ;; 1. Blood pressure, other cardiovascular findings, including
+43 ;; status of peripheral vessels.
+44 ;;
+45 ;;
+46 ;; 2. Neurologic examination.
+47 ;;
+48 ;;
+49 ;; 3. Eye examination.
+50 ;;
+51 ;;
+52 ;; 4. Skin examination.
+53 ;;
+54 ;;
+55 ;; 5. Examination of extremities, including feet.
+56 ;;
+57 ;;
+58 ;; 6. State if the veteran has bladder or bowel functional impairment.
+59 ;; If present, state whether partial or total, intermittent or
+60 ;; constant, and what measures are taken as a result of the impairment.
+61 ;;
+62 ;;
+63 ;;D. Diagnostic and Clinical Tests:
+64 ;;
+65 ;; Provide to establish diagnosis (Previously done test results should
+66 ;; be given to establish diagnosis.):
+67 ;; 1. Renal function tests, including 24 hour urine test for protein
+68 ;; if renal involvement is uncertain.
+69 ;; 2. Blood sugar.
+70 ;; 3. Urinalysis.
+71 ;; 4. Glucose tolerance test, if necessary to establish the diagnosis.
+72 ;; 5. Include results of all diagnostic and clinical tests conducted
+73 ;; in the examination report.
+74 ;;
+75 ;;
+76 ;;E. Diagnosis:
+77 ;;
+78 ;; Comment on:
+79 ;; 1. All complications noted - visual, cardiac, vascular, nephrologic,
+80 ;; neurologic (including both peripheral neuropathy and cerebral
+81 ;; effects), amputations. See examination worksheets for the
+82 ;; conditions found.
+83 ;;
+84 ;;
+85 ;;Signature: Date:
+86 ;;END
