ICD-10: E09.628

ICD-10 code E09.628 refers to Drug or Chemical Induced Diabetes Mellitus with Other Skin Complications. This classification falls under the broader category of diabetes mellitus induced by external factors, specifically drugs or chemicals, and highlights the associated skin complications that can arise from this condition.

Clinical Description

Overview of Drug or Chemical Induced Diabetes Mellitus

Drug or chemical induced diabetes mellitus (E09) occurs when certain medications or chemicals lead to the development of diabetes. This can happen through various mechanisms, including insulin resistance, impaired insulin secretion, or direct toxicity to pancreatic beta cells. Common culprits include:

• Glucocorticoids: Often used for inflammatory conditions, these can increase blood glucose levels.
• Antipsychotics: Some medications in this category can lead to weight gain and insulin resistance.
• Certain antiviral drugs: These may also affect glucose metabolism.

Skin Complications

The skin complications associated with drug or chemical induced diabetes can vary widely and may include:

• Infections: Individuals with diabetes are more susceptible to skin infections due to impaired immune response and poor wound healing.
• Dermatological Conditions: Conditions such as diabetic dermopathy, necrobiosis lipoidica, and acanthosis nigricans can occur.
• Ulcers: Diabetic foot ulcers are a significant concern, often resulting from neuropathy and poor circulation.

Symptoms and Diagnosis

Patients with E09.628 may present with symptoms typical of diabetes, such as:

• Increased thirst and urination
• Fatigue
• Blurred vision
• Slow-healing sores or frequent infections

Diagnosis typically involves:

• Blood Tests: Fasting blood glucose, oral glucose tolerance tests, and HbA1c levels to assess long-term glucose control.
• Medical History: A thorough review of the patient's medication history to identify potential drug-induced causes.

Management and Treatment

Management of drug or chemical induced diabetes mellitus with skin complications involves:

1. Medication Review: Identifying and, if possible, discontinuing or substituting the offending drug.
2. Blood Glucose Control: Implementing lifestyle changes, such as diet and exercise, and possibly using antidiabetic medications.
3. Skin Care: Addressing any skin complications through appropriate dermatological treatments, including antibiotics for infections and topical therapies for skin lesions.

Monitoring

Regular monitoring of blood glucose levels and skin condition is essential to prevent complications and manage the disease effectively. Patients should also be educated about the signs of skin infections and the importance of maintaining good hygiene.

Conclusion

ICD-10 code E09.628 encapsulates a significant clinical condition where drug or chemical exposure leads to diabetes mellitus accompanied by various skin complications. Understanding the underlying causes, symptoms, and management strategies is crucial for healthcare providers to ensure effective treatment and improve patient outcomes. Regular follow-up and patient education play vital roles in managing this condition and preventing further complications.

The ICD-10 code E09.628 refers to "Drug or chemical induced diabetes mellitus with other skin complications." This classification is used to identify cases of diabetes that arise as a result of drug or chemical exposure, accompanied by various skin-related issues. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation

Overview of Drug-Induced Diabetes

Drug or chemical induced diabetes mellitus occurs when certain medications or substances lead to the development of diabetes. This can happen through mechanisms such as insulin resistance or direct damage to pancreatic beta cells. Common drugs associated with this condition include glucocorticoids, antipsychotics, and certain chemotherapy agents[1].

Skin Complications

Patients with drug-induced diabetes may experience a range of skin complications, which can include:
- Infections: Increased susceptibility to bacterial and fungal infections due to impaired immune response.
- Dermatological Conditions: Conditions such as acanthosis nigricans, which presents as dark, velvety patches of skin, often in body folds.
- Delayed Wound Healing: Impaired healing processes can lead to chronic wounds or ulcers, particularly in the lower extremities[2].

Signs and Symptoms

Common Symptoms of Diabetes

Patients may exhibit classic symptoms of diabetes, which include:
- Polyuria: Increased urination due to elevated blood glucose levels.
- Polydipsia: Excessive thirst as the body attempts to compensate for fluid loss.
- Polyphagia: Increased hunger resulting from the body’s inability to utilize glucose effectively.
- Fatigue: Generalized tiredness due to energy depletion at the cellular level[3].

Specific Skin Symptoms

In addition to the general symptoms of diabetes, patients may present with specific skin-related symptoms, such as:
- Skin Infections: Frequent skin infections, particularly in areas prone to moisture.
- Dry Skin: Dehydration can lead to dry, flaky skin.
- Changes in Skin Color: Hyperpigmentation or other discolorations may occur, particularly in areas affected by insulin resistance[4].

Patient Characteristics

Demographics

• Age: Drug-induced diabetes can occur in individuals of any age, but it is more commonly observed in adults, particularly those over 40 years old.
• Gender: There may be a slight male predominance, depending on the specific drugs involved and their usage patterns[5].

Medical History

• Medication Use: A detailed history of medication use is essential, as certain drugs are more likely to induce diabetes. This includes long-term use of corticosteroids, atypical antipsychotics, and some antiretroviral therapies.
• Pre-existing Conditions: Patients with a history of obesity, metabolic syndrome, or other endocrine disorders may be at higher risk for developing drug-induced diabetes[6].

Lifestyle Factors

• Diet and Exercise: Sedentary lifestyle and poor dietary habits can exacerbate the effects of drug-induced diabetes, leading to more pronounced symptoms and complications.
• Substance Use: Use of certain recreational drugs or chemicals may also contribute to the development of diabetes and its complications[7].

Conclusion

ICD-10 code E09.628 captures a specific subset of diabetes mellitus that is induced by drugs or chemicals, characterized by various skin complications. Recognizing the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is vital for healthcare providers. Early identification and management can help mitigate complications and improve patient outcomes. Regular monitoring and a comprehensive approach to treatment, including lifestyle modifications and careful medication management, are essential for patients affected by this condition.

References

1. Therapeutic Shoes for Persons with Diabetes - Policy Article
2. ICD-10 Code for Type 2 diabetes mellitus with other skin complications
3. Thyroid Testing - ICD 10
4. ICD-10-CM Code for Diabetes mellitus due to underlying conditions
5. Cardiology ICD-10 Codes & Classifications - MPR
6. Getting Ready for ICD-10: How It Will Affect Your Practice
7. Thyroid Testing

ICD-10 code E09.628 refers to "Drug or chemical induced diabetes mellitus with other skin complications." This classification falls under the broader category of diabetes mellitus, specifically focusing on cases where diabetes is a result of drug or chemical exposure, accompanied by skin-related issues. Below are alternative names and related terms that can be associated with this code:

Alternative Names

1. Drug-Induced Diabetes: This term broadly describes diabetes that arises as a side effect of certain medications or chemicals.
2. Chemical-Induced Diabetes: Similar to drug-induced diabetes, this term emphasizes the role of chemical exposure in the development of diabetes.
3. Secondary Diabetes Mellitus: This term is often used to describe diabetes that is secondary to other conditions, including drug or chemical exposure.
4. Medication-Induced Diabetes: This phrase specifically highlights the role of medications in triggering diabetes.

Related Terms

1. Skin Complications of Diabetes: This encompasses various skin issues that can arise in diabetic patients, including infections, ulcers, and other dermatological conditions.
2. Diabetes Mellitus with Skin Manifestations: A broader term that includes any form of diabetes that presents with skin complications.
3. Adverse Drug Reaction: This term refers to any harmful or unintended response to a medication, which can include the development of diabetes.
4. Endocrine Disorders: A general category that includes various hormonal imbalances, including those caused by drugs or chemicals leading to diabetes.
5. Metabolic Syndrome: While not directly synonymous, this term relates to a cluster of conditions that increase the risk of heart disease and diabetes, which can sometimes be influenced by medications.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and coding conditions accurately. It also aids in communication among medical teams and ensures that patients receive appropriate care for their specific type of diabetes and associated complications.

In summary, ICD-10 code E09.628 is associated with various alternative names and related terms that reflect the nature of drug or chemical-induced diabetes and its skin complications. Recognizing these terms can enhance clarity in clinical documentation and patient management.

The diagnosis of ICD-10 code E09.628, which refers to drug or chemical induced diabetes mellitus with other skin complications, involves specific criteria that healthcare providers must consider. This code is part of the broader classification of diabetes mellitus and is used to identify cases where diabetes is a result of medication or chemical exposure, accompanied by skin-related complications.

Diagnostic Criteria for E09.628

1. Medical History

• Medication Review: A thorough review of the patient's medication history is essential. This includes identifying any drugs or chemicals that are known to induce diabetes mellitus. Common culprits include corticosteroids, certain antipsychotics, and other medications that can affect glucose metabolism.
• Chemical Exposure: Consideration of any exposure to chemicals that may lead to diabetes, such as those encountered in occupational settings.

2. Clinical Symptoms

• Diabetes Symptoms: Patients may present with classic symptoms of diabetes, including increased thirst (polydipsia), frequent urination (polyuria), fatigue, and blurred vision. These symptoms should be evaluated in the context of recent medication changes or chemical exposure.
• Skin Complications: The presence of skin complications is a critical aspect of this diagnosis. These may include:
  • Skin infections
  • Diabetic dermopathy
  • Acanthosis nigricans
  • Other dermatological manifestations associated with diabetes

3. Laboratory Tests

• Blood Glucose Levels: Elevated blood glucose levels are necessary for diagnosing diabetes. This can be assessed through:
  • Fasting blood glucose test
  • Oral glucose tolerance test (OGTT)
  • Hemoglobin A1c test, which provides an average blood glucose level over the past two to three months.
• Exclusion of Other Causes: It is important to rule out other potential causes of diabetes, such as type 1 diabetes or type 2 diabetes unrelated to drug or chemical exposure.

4. Diagnostic Codes

• ICD-10 Classification: The use of E09.628 specifically indicates that the diabetes is induced by drugs or chemicals and is associated with skin complications. Accurate coding is essential for proper documentation and billing.

5. Clinical Guidelines

• Follow Clinical Guidelines: Healthcare providers should adhere to established clinical guidelines for diagnosing and managing drug-induced diabetes. This includes monitoring and managing blood glucose levels and addressing any skin complications that arise.

Conclusion

In summary, the diagnosis of ICD-10 code E09.628 requires a comprehensive approach that includes a detailed medical history, assessment of clinical symptoms, laboratory testing, and adherence to coding guidelines. Recognizing the link between drug or chemical exposure and diabetes, along with associated skin complications, is crucial for effective patient management and treatment. Proper documentation and coding ensure that patients receive appropriate care and that healthcare providers are reimbursed accurately for their services.

The ICD-10 code E09.628 refers to drug or chemical-induced diabetes mellitus that is accompanied by other skin complications. This condition arises when diabetes is triggered by certain medications or chemicals, leading to various skin issues such as infections, ulcers, or other dermatological manifestations. Understanding the standard treatment approaches for this condition involves addressing both the diabetes management and the specific skin complications.

Understanding Drug-Induced Diabetes Mellitus

Drug-induced diabetes can occur due to various medications, including corticosteroids, antipsychotics, and certain chemotherapy agents. These drugs can affect insulin sensitivity or secretion, leading to elevated blood glucose levels. The management of drug-induced diabetes typically involves:

• Identifying and Modifying Medication: The first step is to review the patient's medication history to identify the offending drug. If possible, switching to an alternative medication that does not induce diabetes is crucial[1].

• Monitoring Blood Glucose Levels: Regular monitoring of blood glucose levels is essential to assess the severity of diabetes and the effectiveness of any interventions[2].

Standard Treatment Approaches

1. Diabetes Management

• Lifestyle Modifications: Patients are encouraged to adopt a healthy diet, engage in regular physical activity, and maintain a healthy weight. These lifestyle changes can significantly improve insulin sensitivity and glycemic control[3].

• Medications: Depending on the severity of hyperglycemia, oral hypoglycemic agents or insulin therapy may be necessary. Common medications include metformin, sulfonylureas, or insulin analogs, tailored to the patient's specific needs and health status[4].

2. Management of Skin Complications

• Topical Treatments: For localized skin issues, topical treatments such as antibiotics for infections or corticosteroids for inflammation may be prescribed. These can help manage symptoms and prevent further complications[5].

• Wound Care: If the patient has ulcers or other wounds, proper wound care is critical. This may involve debridement, dressing changes, and possibly negative pressure wound therapy to promote healing[6].

• Infection Control: Patients with diabetes are at a higher risk for skin infections. Prompt treatment with appropriate antibiotics is essential if an infection is suspected[7].

3. Regular Follow-Up and Monitoring

• Dermatological Assessments: Regular follow-ups with a dermatologist may be necessary to monitor skin conditions and adjust treatments as needed[8].

• Endocrinology Consultations: Involving an endocrinologist can help optimize diabetes management, especially if the patient has complex needs or if the diabetes is difficult to control[9].

Conclusion

Managing drug or chemical-induced diabetes mellitus with skin complications requires a comprehensive approach that addresses both the underlying diabetes and the specific dermatological issues. By modifying medications, implementing lifestyle changes, and providing targeted treatments for skin complications, healthcare providers can significantly improve patient outcomes. Regular monitoring and interdisciplinary collaboration are key to ensuring effective management of this condition. If you have further questions or need more specific information, feel free to ask!