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CONDITION/DISORDER SYNONYMS

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  • Juvenile diabetes

  • Diabetes type 1

  • Diabetes type 1.5

  • Diabetes type 2

  • Gestational diabetes

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ICD-9-CM CODES

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  • 249.91 Secondary diabetes mellitus with unspecified complication, uncontrolled

  • 250 Diabetes mellitus

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ICD-10-CM CODES

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  • E08.65 Diabetes mellitus due to underlying condition with hyperglycemia

  • E08.8 Diabetes mellitus due to underlying condition with unspecified complications

  • E09.8 Drug or chemical-induced diabetes mellitus with unspecified complications

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PREFERRED PRACTICE PATTERNS

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  • As of June, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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PATIENT PRESENTATION

A 30-year-old woman presents to the physician’s office with the chief complaint of a “yeast infection that I can’t seem to shake.” She also has noticed that she has been urinating more frequently, but thinks that it is related to her yeast infection. Over the last several years she has noticed that she has gained more than 40 lb. She has tried numerous diets, most recently a low-carbohydrate, high-fat diet. The patient’s only other pertinent history is that she was told to watch her diet during pregnancy because of excessive weight gain. Her baby had to be delivered by cesarean because he weighed more than 9 lb. Her family history is not known, as she was adopted. On physical examination, her blood pressure is 138/88 mm Hg, her pulse is 72 beats/min, and her respiratory rate is 16 breaths/min. Her height is 65 in and her weight is 190 lb (body mass index [BMI] = 31.6). Her physical examination reveals darkened skin that appears to be thickened on the back of her neck and moist, reddened skin beneath her breasts. Her pelvic examination reveals a thick, white, vaginal discharge. A wet preparation from the vaginal discharge reveals branching hyphae consistent with Candida. A urine dipstick is performed that is negative for leukocyte esterase, nitrites, protein, and glucose.1

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FIGURE 22-1

Diabetes mellitus: atrophy of skin (necrobiosis diabeticorum) of legs with coronary disease. (From Fuster V, Walsh RA, Harrington RA. Hurst’s The Heart. 13th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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KEY FEATURES

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Description
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  • Diabetes mellitus

    • Primary diabetes mellitus

      • Type 1: Inability of the body to produce insulin, formerly referred to as juvenile diabetes

      • Type 1.5: Latent autoimmune diabetes in adults (LADA), signs of both type 1 and type 2 diabetes where the body can initially produce some insulin but ultimately cannot

      • Type 2: Insulin resistance; inability of the body to produce adequate insulin or inability for adequate insulin uptake by the body to sufficiently regulate insulin/glucose, some insulin is produced by the pancreas

      • Impaired glucose tolerance (IGT)

      • Gestational diabetes ...

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