CLINIBORG
Home
Contents
Recent
Privacy Policy
Terms
About
Diabetes Mellitus History
Mar 8, 2013
•
Mark Morgan
categories:
Endocrine, Nutrition & Obesity
Subjective/History
Diabetes mellitus
Type 2
Type 1
, diagnosed in
In reviewing the history, the patient is followed
by a primary care physician
by the diabetes clinic
by primary care physician and diabetes clinic
by the family medicine team
other
.
In the past year the patient has had the following diabetic visits:
no
one
two
three
four
five
more than five
visits in the hospital,
no
one
two
three
four
five
more than five
visits to the ER, and
no
one
two
three
four
five
more than five
outpatient visits.
The patient
is following an optimal diet
is having difficulties following the diet
is not following a diet
would like further education on their diet
. The patient has
no
some
specific concerns about diet.
specific diet concern details...
speech input
.
The patient routinely exercises
never
once a week
2 times a week
3 times a week
4 times a week
5 times a week
6 times a week
7 times a week
. The type of exercise is
. Overall, the patient is exercising
approximately
more than
less than
150 minutes per week.
The patient has a history of the following diabetes complications:
NO
YES
<-- Diabetic ketoacidosis
NO
YES
<-- Hyperosmolar hyperglycemic state
NO
YES
<-- Hypoglycemic episodes
NO
YES
<-- Eye complications
NO
YES
<-- Nephropathy
NO
YES
<-- Neuropathy
NO
YES
N/A
<-- Obstetric complications
The following prevention program has been set up and includes:
one time Pneumovax
yearly vaccination with Influenza
foot care instruction
preconception counseling
MONITORING:
The patient performs monitoring of blood glucose
once a day
twice a day
three times a day
four times a day
once a week
twice a week
three times a week
at no specific times
at clinic visits
.
The patient's goals for diabetes control are:
MORNING (FASTING) BLOOD SUGAR LESS THAN 130.
BLOOD SUGAR PRIOR TO MEALS OF 80-120.
BEDTIME BLOOD SUGAR LESS THAN 120.
HEMOGLOBIN A1C LESS THAN 7 WITHOUT SIGNIFICANT SYMPTOMS.
HEMOGLOBIN A1C LESS THAN 8.
Other:
.
INSULIN
The patient
does not use insulin
uses long-acting insulin only
uses short-acting insulin only
uses long- and short-acting insulins
.
The patient does not adjust insulin.
The patient adjusts short-acting insulin based on glucose checks before meals.
The patient adjusts short-acting insulin based on carbohydrate counting.
The patient adjusts long-acting insulin based on fasting glucose trend.
3 by 3 long-acting insulin adjustment instruction for patients
Calculate The Result!
Reset Form
Result - Copy and paste this output:
Copy to Clipboard
Please enable JavaScript to view the
comments powered by Disqus.