You may find cardiovascular abnormalities if your patient’s diabetes hasn’t been diagnosed or if she’s having difficulty controlling her blood glucose levels with her prescribed treatment.Most cardiac abnormalities are detected during the health history and through diagnostic tests rather than during the physical examination. If your patient has peripheral vascular disease, you may find abnormal skin changes. When palpating the peripheral pulses, especially the pedal pulse, you may note a decreased or absent pulse.

To check arterial competence, have your patient elevate her legs while she moves her feet up and down. Then have her sit with her legs dangling, normal color should return to her legs in about 10 seconds. A slowly developing dusky color indicates arterial insufficiency