Begin the health history by gathering biographical information about your patient. If you suspect she has diabetes, make sure you note her age, ethnic group, and living arrangements.

Your patient’s age at the time of diagnosis provides a clue to the type of diabetes. Type 1 diabetes usually begins in early adolescence, Type 2, after age 35. Use caution, however; a patient over age 35 can be diagnosed with Type 1 diabetes, and a child can be diagnosed with Type 2 diabetes.

A person’s ethnic group may be a risk factor for diabetes. Mexican-Americans, Native Americans, and African-Americans have a higher rate of diabetes than those in other groups.

Whether a person lives alone has nothing to do with the disease process, of course, but it may have a lot to do with disease management. A spouse or partner who cooks for the patient can have a tremendous impact on the dietary aspect of diabetes treatment. And a spouse or partner can also provide much needed emotional support as the patient undergoes lifestyle changes to control her blood glucose levels.

Chief Complaint

Common chief complaints include polyuria, polydipsia, polyphagia, and weight loss. With diabetes, the patient feels constantly hungry because the glucose that usually feeds body cells remains in the blood. Excessive urination occurs as the kidneys try to eliminate the glucose from the blood. As glucose leaves the body through urine, the body loses water, which results in dehydration and thirst. Weight loss develops as cells are deprived of their main energy source-glucose.

Polyuria, polydipsia, and polyphagia may be pronounced in patients with Type 1 diabetes because the loss of insulin occurs abruptly. These signs can also develop in Type 2 diabetes, but because the loss of insulin occurs more slowly, they’re usually milder and are commonly over­looked. Other symptoms include fatigue and weakness.

In many cases, Type 2 diabetes goes undetected for many years. Therefore, a patient’s chief complaint may result from a complication of diabetes rather than the diabetes itself. Complaints of visual disturbances, neurologic impairment, cardiovascular dysfunction, or frequent infections should alert you to question the patient more closely about signs and symptoms of diabetes.