A complete endocrine and metabolic assessment addresses each of the following each visit, scaled to the patient’s condition and orders, and compares each finding to baseline.
Glucose monitoring — the self-monitoring or continuous-glucose log, reviewed for the pattern, hypoglycemic events, and hyperglycemic excursions against the patient’s individualized ordered targets.
Monitoring and insulin technique — meter or sensor use, insulin drawing and injection or pump operation, site rotation, and storage, observed directly.
Hypoglycemia surveillance — symptoms, frequency, hypoglycemia unawareness, and the availability of a rescue (oral carbohydrate, glucagon per order).
Hyperglycemia and acute-decompensation surveillance — polyuria, polydipsia, dehydration, Kussmaul respirations or fruity breath, and mental-status change.
Diabetic foot screen — skin integrity and protective-sensation status (test and detail documented in Touch/Sensation; wounds in Wounds).
Thyroid surveillance — heat or cold intolerance, palpitations, tremor, weight change, fatigue, and replacement adherence (systemic and neck exam in Neck/Thyroid).
Adrenal and steroid surveillance — steroid regimen, signs of insufficiency or excess, and sick-day or stress-dose understanding in steroid-dependent patients.
Medication regimen — insulin, oral and injectable agents, thyroid replacement, and corticosteroids, with adherence and effect.
Hydration and metabolic status, and relevant laboratory trends where available (glucose, A1c, electrolytes, renal function).
Functional and cognitive baseline as it bears on safe self-management and recognizing decompensation (cross-reference Cognitive).
