PATIENT MONITORING
- Frequency of followup depends on compliance and degree of metabolic control. Every two to four months is typical.
- Review of symptoms and home blood glucose levels
- Hemoglobin A1c
- Funduscopy
- Cardiopulmonary exam
- Foot exam for ulcers, arterial insufficiency, neuropathy
- After five years, perform yearly: Ophthalmologist exam, monitor for proteinuria and renal insufficiency
PREVENTION/AVOIDANCE
Avoidance of weight gain and obesity and maintenance of regular physical activity may prevent or delay NIDDM
POSSIBLE COMPLICATIONS
- Appear to be due to effects of diabetes mellitus on arterial walls in one form or another
- Peripheral neuropathy
- Proliferative retinopathy
- Nephropathy and chronic renal failure
- Atherosclerotic cardiovascular and peripheral vascular disease
- Hyperosmolar coma
- Gangrene of extremities
- Blindness
- Glaucoma
- Cataracts
- Skin ulceration
- Charcot joints
EXPECTED COURSE/PROGNOSIS
- Maintenance of normal blood sugar levels may delay or prevent complications of diabetes
- In susceptible individuals, complications begin to appear 10-15 years after onset, but can be present at time of diagnosis since disease may go undetected for years
