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Symptoms: Diabetes ‘Out of Control’

Greenberg, Michael I. MD, MPH

Doorway Diagnosis

Dr. Greenberg is a professor of emergency medicine and public health, the chief of the division of occupational/environmental emergency medicine, and the toxicology fellowship program director at the Drexel University College of Medicine in Philadelphia.

A 44-year-old woman presents to the ED because she “thinks her diabetes is out of control.” After the requisite lab testing (blood sugar is normal and there is no sugar in the urine), you reassure her that her diabetes seems to be under adequate control at the moment but that she should follow-up with her primary care physician as soon as possible.

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Before the patient leaves, she asks you to take a look at her great toe nail. You see the nail depicted in the photograph.

What is your doorway diagnosis? See p. 40.

© 2003 Lippincott Williams & Wilkins, Inc.