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DM CSCS-1

Diabetes
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0% found this document useful (0 votes)
11 views

DM CSCS-1

Diabetes
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CLINICO SOCIAL CASE STUDY/BEDSIDE CLINICS

DIABETES MELLITUS
Identification Data:
Ward No. Bed No.: OP/IP No. Date of Admission
Name of the Patient
Age Sex:

Address: Education: Occupation:

Presenting complaints and duration : (ask about DM/DM complications related symptoms)

History of presenting complaints

Past History:

Treatment history: (ask about drugs, compliance)

Family History:

1
Personal history:
1. Tobacco use: current/ past/ never
If current user:
Form: smokeless/ smoke/ both Quantity:
Duration of the habit:
if past user reason for quitting:
if never used, history of Passive smoking: Present/ No

2. Alcohol consumption: current/ past/ never


If current, occasional /regular (two or more times a week)
Duration of the habit
If past user, reason for quitting:
Any other substance abuse? Specify:

3. Physical activity:

At work: sedentary/ moderate/ heavy

At home/ out of home: sedentary/ moderate/ heavy

Perception of chronic psychological stress: yes/no

Diet history:
Vegetarian/ both veg& non-veg

No. of days vegetables consumed per week:

No. of days fruits consumed per week:

No. of days junk food consumed per week:

Food restrictions if any:

Describe a typical day’s diet:

Calculated calorie intake/day:

2
Comment on diet of the individual:

SELF-CARE PRACTICES:

Goes for regular blood sugar examination as advised? Yes/no

Knows to check feet regularly? Yes/no

Goes for check-ups as advised? Yes/no

Knows symptoms/signs of hypoglycemia? Yes/ no

Knows symptoms/signs of hyperglycemia? Yes/no

Any changes in lifestyle after the diagnosis?(regarding physical activity &diet)

Socioeconomic Details:
Type of family: nuclear/ three generation/ joint. Total. No of family members:
Total Family Income Per capita Income:
Ration Card : Absent/Pink/White
Socioeconomic status:

Environment History:
House: (comment on housing status, in terms of over-crowding, ventilation, In-door pollution)

Drinking water purification method:


Source of drinking water:
Toilet Facility:
Mosquito breeding sites: Present/Not present

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General Examination :

Vitals:

Pulse Rate: B.P.: Temp: R.R

Anthropometry:
Height: Weight: BMI:
Waist circumference: Hip circumference: W/H Ratio:

Systemic Examination (Examine the relevant system based on Presenting


complaints):

Examination of foot:( if any cracks, ulcers, corns; loss of sensation, foot wear use)

Investigations: Done / Suggested


FBS: PPBS:
HbA1c (Glycosylated Haemoglobin):
Any other investigations done/suggested:

Clinico- social Diagnosis:

Management:

4
Advise to the patient

QUESTIONS:

1) What are the diagnostic criteria for Diabetic Mellitus?

2) How do you classify Diabetes Mellitus?

3) What are the self-care practices in Diabetes Mellitus?

4) What are the common complications of Diabetes Mellitus?

5) What is the national health program for non-communicable diseases?

6) Did the person make any changes in his/her lifestyle after the diagnosis?

7) What are the risk factors for diabetes in this person?

8) Failure at what level/s of prevention responsible for this stage of disease?

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