Diabets history taking

I- Presenting complaint :

Ask the patient about the most distressing symptom that made
him seek medical advice . ( in addition to its duration )

• poluuria
• nocturia
• polydesia
• dysuria
• polyphagia
• pruritis
• tingling & numbness in limbs
• Loss of sensation in limbs
• Loosening of teeth .
• Blurring of vision .
• Erectile dysfunction .

II- History of present illness :

A- Analysis of all mentioned symptoms by the patient :

1) Onset (when did the symptom start? / was the

onset acute or gradual?).
2) Duration (minutes / hours / days / weeks / months
/ years).
3) Severity (mild / moderate / severe).
4) Course (Intermittent or continuous?)
5) Precipitating factors.
6) Relieving factors.
7) time of diagnosis of DM .
8) type of DM at time of diagnosis .

B- Exclusion of symptom of other system affection :

1)- Cardiac diseases :
• Hypertension ( headache / episatxis )
• Heart failure ( orthopnea / lower limb oedema )
• Ischemic heart disease ( exertional dyspnea / chest pain )

2)- Neurological affection :

• Peripheral neuropathy
Sensory : ( tingling / numbness / slipped slippers /
cotton sensation on walking / lost peripheral sensation )
Motor : ( lower limb weaknesss at thigh muscles )
Autonomic :
CVS : orthostatic hypotension / resting tachycardia
Skin : skin dryness .
GIT : gastroparesis ( dyspepsia / nausea / fullness )
/ diarrhea OR constipation .
Urological : neurogenic bladder ( urine dribbling /
urinary incontinence / small urine volume
during voiding )
Genital : male ( erectile dysfunction )
Female ( loss of vaginal lubrication )
Papillary : Argyll Robertson pupil ( failure of light
adaptaion )

3)- Renal complication : oliguria / anuria / frothy urine /

pruritis / nausea & vomiting

4)- Retinopathies : visual field defect / tubular vision /

deterioration of visual acuity .

5)- lower limb : amputation / nail colour changes / loss of hair /

claudication pain

6)- Respiratory diseases : bronchial asthma/ infection ( TB ) .

7)- other endocrinological diseases :

Acromegaly / Cushing syndrome / thyrotoxicosis /
hypothyroidism / pheochromocytoma .

8)- Autoimmune diseases : vetiligo / SLE / rheumatoid

arthritis / MS / IBD .
III-Past medical history :

1)- previous acute DM emergencies ( DKA / hypoglycemia )

2)- previous hospital admissions . ( ward / ICU )
3)- previous surgeries .
4)- other chronic diseases ( HCV/HBV/ ,,, etc )
5)- for females ( abortions / gestational DM / children with congenital
anomalies )

IV- Drug history :

• Type & dose of anti-diabetic medications ( oral / insulin ) .

• Regular medications for chronic diseases.
• Over the counter drugs.
• Forms of the contraception methods for females.
• Immunization (any type of vaccinations given).

V- Social history :

o Marital status and Sexual history.

o Menstrual history, seeking fertility or not.
o Contact with canal water.
o Residency.
o Occupation and Daily activities.
o Recent travel.

Special habits of medical importance :

❖ Smoking (type / number per day / for how long).

❖ Alcohol consumption (type / frequency / duration).
❖ Recreational drug use.

VI- Family history :

A)- family members having DM / cardiac diseases / similar condition

B)- Autoimmune diseases .
C)- endocrine diseases ( thyroiditis / adrenal insufficiency )
D)- metabolic syndrome .
E)- parents consanguinity .