Diabetic History (OSCE)

Type and Duration

• Type1DM or Type2DM? Consider other types such as Gestational diabetes and LADA.
• AGE of onset
• MANNER of diagnosis - Routine Tests or Symptomatic, if symptomatic explore presenting symptoms

Glucose Control

• FREQUENCY of monitoring
• VALUES - usual numbers at AM and PM, taken AC or PC, range, HbA1c

• HYPOGLYCEMIC episodes
  • frequency
  • severity
  • sympathetic prodrome
  • unheralded neuroglycopenic symptoms
    • hunger, dizziness, tingling, blurred vision, difficulty thinking, and faintness

Please give time interval between last meal and fasting blood sugar test and values in all tests.It will help people.

Diet and Exercise (CDA)

• quantity (calories)
• quality

Medications

• oral hypoglycemics
• insulin (type, units, timing)
• antagonistic drugs (thiazides, corticosteroids)

Modifiable Risk Factors

• Hypertension
• Hypercholesterolemia
• Smoking
• Alcohol

PMHx

• Stroke
• MI

ROS

Neuropathy

• Neuropathy
• Autonomic:
  • erectile dysfunction
  • orthostatic hypotension
  • gastroparesis
  • constipation
  • incontinence

• Peripheral:
  • anesthesia
  • paresthesia
  • hyperesthesia

Retinopathy

• date of last eye exam with an OPHTHALMOLOGIST (MD/DO)

Nephropathy

• renal disease
• proteinuria or microalbuminuria
• last URINE ANALYSIS
• last serum creatinine

Vascular

Cardiac

• angina
• dyspnea
• orthopnea(under pulmonary)
• CHF
• MI

Peripheral Vascular Disease

• claudication
• foot care

Hospitalization

• Hypoglycemia
• DKA
• HONKS (hyperosmolar nonketotic state)

Other OSCE Modules