Clinical features

The classical symptoms of uncontrolled diabetes are:

• polydipsia

tiredness and fatigue

• propensity for infections, especially of the skin and genitals (vaginal thrush)

The young insulin dependent diabetic typically presents with a brief 2-4 week history of the classic triad of symptoms:

Thirst Polyuria Weight loss

Other symptoms are:

• vulvovaginitis (due to Candida albicans)

• pruritus vulvae (due to Candida albicans)

• balanitis (due to Candida albicans)

nocturnal enuresis (type I)

• blurred vision/visual changes

Symptoms of complications (may be presenting feature)

• staphylococcal skin infections

• polyneuropathy o tingling or numbness in feet o pain (can be severe if present)

• arterial disease o myocardial ischaemia o peripheral vascular disease

The clinical examination should follow the guidelines under the heading 'Examinations' in Table 17.5 .

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