DVBCWDI4 ;ALB/RLC DIABETES MELLITUS WKS TEXT - 1 ; 24 MAY 2004
;;2.7;AMIE;**131**;Apr 10, 1995;Build 4
;
;
TXT ;
;;When a Diabetes Mellitus examination is requested, begin with this
;;worksheet. For each diabetic complication manifested by the veteran,
;;complete appropriate additional worksheets.
;;Chronic complications from diabetes include vascular and nonvascular
;;complications. Vascular complications include microvascular
;;(eye disease, neuropathy, nephropathy) and macrovascular complications
;;(coronary artery disease, peripheral vascular disease, cerebrovascular
;;disease). Nonvascular complications include gastroparesis, sexual
;;dysfunction, and skin changes.
;;Reference: Harrison's Principles of Internal Medicine, 2001, page 2119.
;;
;;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;
;; As pertains to Diabetes Mellitus or its complications, comment on:
;;
;; 1. Age of onset.
;; 2. Number of episodes of ketoacidosis or hypoglycemic reactions
;; requiring hospitalizations per year. Location.
;; 3. Restricted diet.
;; 4. Weight loss or gain since last exam.
;; 5. Describe any restriction of activities on account of the
;; diabetes (e.g., avoiding strenuous activity to prevent
;; hypoglycemic reactions).
;; 6. Treatment - oral hypoglycemic, insulin (frequency of injections),
;; side effects.
;; 7. Current frequency of visits to diabetic care provider due to
;; ketoacidosis or hypglycemic reactions or within past year.
;; 8. Other symptoms, such as anal pruritus, loss of strength.
;; 9. Visual problems. Refer to examination worksheet: Eye
;; examination, if indicated.
;; 10. Vascular (including hypertension, if appropriate) or cardiac
;; symptoms. Refer to examination worksheet(s): Hypertension,
;; Heart, Arteries, Veins, and Misc., etc., if indicated.
;; 11. Neurologic symptoms. Refer to examination worksheet(s):
;; Peripheral Nerves, etc., if indicated.
;; 12. Bladder or bowel functional impairments. Refer to examination
;; worksheet(s): Genitourinary, Rectum and Anus exam, etc., if
;; indicated.
;; 13. Effects of the condition on occupational functioning and daily
;; activities.
;;
;;C. Physical Examination (Objective Findings):
;;
;; Assess for chronic complications of diabetes mellitus. Complete
;; appropriate additional worksheets.
;;
;; 1. Eye examination.
;; 2. Cardiac examination to include blood pressure and status of
;; peripheral arteries, presence of peripheral edema.
;; 3. Neurologic examination.
;; 4. Skin examination.
;; 5. Examination of extremities, including feet.
;;
;;D. Diagnostic and Clinical Tests:
;;
;; Provide:
;;
;; 1. Fasting blood sugars or other laboratory evaluation, such as
;; glucose tolerance test, if necessary to establish the diagnosis.
;; 2. Blood sugars.
;; 3. Evaluation for kidney function including: urinalysis with urine
;; for microalbumnuria; blood urea nitrogen (BUN) and creatinine (Cr).
;; 4. Other test to confirm or evaluate complications. Follow
;; appropriate worksheets for guidance on the tests.
;; 5. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWDI4 3595 printed Dec 13, 2024@01:50:16 Page 2
DVBCWDI4 ;ALB/RLC DIABETES MELLITUS WKS TEXT - 1 ; 24 MAY 2004
+1 ;;2.7;AMIE;**131**;Apr 10, 1995;Build 4
+2 ;
+3 ;
TXT ;
+1 ;;When a Diabetes Mellitus examination is requested, begin with this
+2 ;;worksheet. For each diabetic complication manifested by the veteran,
+3 ;;complete appropriate additional worksheets.
+4 ;;Chronic complications from diabetes include vascular and nonvascular
+5 ;;complications. Vascular complications include microvascular
+6 ;;(eye disease, neuropathy, nephropathy) and macrovascular complications
+7 ;;(coronary artery disease, peripheral vascular disease, cerebrovascular
+8 ;;disease). Nonvascular complications include gastroparesis, sexual
+9 ;;dysfunction, and skin changes.
+10 ;;Reference: Harrison's Principles of Internal Medicine, 2001, page 2119.
+11 ;;
+12 ;;
+13 ;;A. Review of Medical Records:
+14 ;;
+15 ;;B. Medical History (Subjective Complaints):
+16 ;;
+17 ;; As pertains to Diabetes Mellitus or its complications, comment on:
+18 ;;
+19 ;; 1. Age of onset.
+20 ;; 2. Number of episodes of ketoacidosis or hypoglycemic reactions
+21 ;; requiring hospitalizations per year. Location.
+22 ;; 3. Restricted diet.
+23 ;; 4. Weight loss or gain since last exam.
+24 ;; 5. Describe any restriction of activities on account of the
+25 ;; diabetes (e.g., avoiding strenuous activity to prevent
+26 ;; hypoglycemic reactions).
+27 ;; 6. Treatment - oral hypoglycemic, insulin (frequency of injections),
+28 ;; side effects.
+29 ;; 7. Current frequency of visits to diabetic care provider due to
+30 ;; ketoacidosis or hypglycemic reactions or within past year.
+31 ;; 8. Other symptoms, such as anal pruritus, loss of strength.
+32 ;; 9. Visual problems. Refer to examination worksheet: Eye
+33 ;; examination, if indicated.
+34 ;; 10. Vascular (including hypertension, if appropriate) or cardiac
+35 ;; symptoms. Refer to examination worksheet(s): Hypertension,
+36 ;; Heart, Arteries, Veins, and Misc., etc., if indicated.
+37 ;; 11. Neurologic symptoms. Refer to examination worksheet(s):
+38 ;; Peripheral Nerves, etc., if indicated.
+39 ;; 12. Bladder or bowel functional impairments. Refer to examination
+40 ;; worksheet(s): Genitourinary, Rectum and Anus exam, etc., if
+41 ;; indicated.
+42 ;; 13. Effects of the condition on occupational functioning and daily
+43 ;; activities.
+44 ;;
+45 ;;C. Physical Examination (Objective Findings):
+46 ;;
+47 ;; Assess for chronic complications of diabetes mellitus. Complete
+48 ;; appropriate additional worksheets.
+49 ;;
+50 ;; 1. Eye examination.
+51 ;; 2. Cardiac examination to include blood pressure and status of
+52 ;; peripheral arteries, presence of peripheral edema.
+53 ;; 3. Neurologic examination.
+54 ;; 4. Skin examination.
+55 ;; 5. Examination of extremities, including feet.
+56 ;;
+57 ;;D. Diagnostic and Clinical Tests:
+58 ;;
+59 ;; Provide:
+60 ;;
+61 ;; 1. Fasting blood sugars or other laboratory evaluation, such as
+62 ;; glucose tolerance test, if necessary to establish the diagnosis.
+63 ;; 2. Blood sugars.
+64 ;; 3. Evaluation for kidney function including: urinalysis with urine
+65 ;; for microalbumnuria; blood urea nitrogen (BUN) and creatinine (Cr).
+66 ;; 4. Other test to confirm or evaluate complications. Follow
+67 ;; appropriate worksheets for guidance on the tests.
+68 ;; 5. Include results of all diagnostic and clinical tests conducted
+69 ;; in the examination report.
+70 ;;
