‘OSCE - DIABETES Me Hill, 6oyo obese gentleman has $ years history of noa insulin dependent diabetes. His current Micleatos chses eorain aad hacer hon i). However"ae i avery Gilt patel, being mor-complian wid mulcauom aa rfc w wri for fullywnup. Ic, Ill eventually teday afer your periting ines is bod sugar level (glcometrreating) was found to be 12 ik 4 ‘Skin: Any infections (candida), leg wlers. eet: Normal Cardiovascular: For his heart failure Corotids Resp: any crackles? ‘ear cards (ute hair, uemperature, et ‘Neuro: perpen wuropaty pn ees) sigh os of pn peck (love and snckng) Proximal myopathy. Eyes: Visust acuity ~ normal Visual fields - normal 03 BMI: BMI 321 & Vieale: ” BR, BR, RP dying and etanding ~ anianamic neuropathy) 1 4 Os 1 oe 1 ‘Movements (mononeuritis multiplex) os Fundoscopy . @ What do you see in his eye? ‘Non-proiferative diabetic retinopathy 05 Dot and Blot haemorrhages Hard erdates Micro-aneurysms? z Macular region not affected, 05 ‘How would you manage this patient on this occasion? Investigations FBE, UAE, Cr & glucose, HbAIC ‘Urine ketones / glucose 05 Cholesterol levels 0s Education: importance of glucose control, teach hone ruonitoring. oe Feat care (because loss of sensation) 1 Diet: unrefined carbohydrates, high fibre 7 Risk factor control: : decrease weigh, Ymokngslfobol, exercise 5 Medication BN Change tuna bio anor cast. eo t TOTAL 8