Type 1 Diabetes: Living With the Disease - When To Call a Doctor

When To Call a Doctor

Call 911 or other emergency services immediately if you or your child is:

• Unconscious or becomes very sleepy unexpectedly. You or your child may have low blood sugar, called hypoglycemia. While waiting for emergency help, follow:
  • Emergency care for low blood sugar
  • Emergency care for low blood sugar in a child
• Drowsy, confused, breathing fast, and your or your child’s breath smells fruity or like nail polish. You or your child may have high blood sugar, called hyperglycemia. A life-threatening condition called diabetic ketoacidosis could be present.

Call a doctor immediately if you or your child is vomiting and cannot keep down liquids and:

• Your blood sugar is 300 mg/dL or higher.
• Your child’s blood sugar is 250 mg/dL or higher.

Call a doctor if you or your child:

• Is sick for more than 2 days (unless it is a mild illness, such as a cold), and you or your child:
  • Has been vomiting or had diarrhea for more than 6 hours.
  • Has followed the doctor's advice but it has not worked. Learn what to do when you are sick and have diabetes.
  • Has blood sugar levels that are often above 300 mg/dL and urine tests for ketones show more than 2+ or moderate or higher ketones.
• Has a blood sugar level that stays below the target range after eating some quick-sugar food.
• Has a blood sugar level that stays high after taking a missed dose of insulin or taking an extra dose of insulin (if prescribed by the doctor).
• Has frequent problems with high or low blood sugar levels. The insulin dose or schedule may need to be changed.
• Is having difficulty knowing when blood sugar is low (hypoglycemia unawareness).
• Has problems following the meal plan or getting physical activity, and you want help.

Watchful Waiting

Watchful waiting (or surveillance) is a period of time during which you and your health professional observe your symptoms or condition without using medical treatment. It is not appropriate if you have frequent high or low blood sugar levels. See your health professional. Your treatment may need to be changed.

Also see your health professional if you begin to notice symptoms of complications. Early treatment can prevent complications or keep them from getting worse.

Who To See

Health professionals involved in your treatment may include:

• An endocrinologist or pediatric endocrinologist.
• A family medicine physician.
• A general practitioner.
• An internist.
• An adolescent medicine specialist.
• A pediatrician.
• A nurse practitioner.
• A physician assistant.
• A certified diabetes educator (CDE).
• A registered dietitian.

Who to see for complications

If you begin to have symptoms of complications from diabetes, you may be referred to:

• A cardiologist or vascular specialist, for treatment of heart and circulation problems.
• A nephrologist, for treatment of kidney disease.
• An ophthalmologist or optometrist, for diagnosis and treatment of eye disease; ophthalmologists treat retinal complications from diabetes.
• A neurologist, for treatment of nerve damage.
• A gastroenterologist, for treatment of problems in the stomach and intestines.
• A urologist, for treatment of problems with sexual function or the urinary tract.
• A podiatrist, pedorthist (a certified technician who can make special shoes or shoe inserts), or orthopedic surgeon, for foot and ankle problems.

To prepare for your appointment, see the topic Making the Most of Your Appointment