When To Call a Doctor

Call 911 or other emergency services immediately if you are:

• Unconscious or become very sleepy unexpectedly. You may have low blood sugar, called hypoglycemia. While waiting for emergency help, follow:
  • Emergency care for low blood sugar for people taking insulin.
• Drowsy, confused, breathing fast, and your breath smells fruity. You may have high blood sugar, called hyperglycemia. A life-threatening condition called diabetic ketoacidosis could be present.
• Having new or sudden vision loss. You may have a retinal detachment or bleeding within the eye.
• Chest discomfort or pain that is crushing, squeezing, or feels like a heavy weight on the chest. You could be having a heart attack. Other symptoms of a heart attack include:
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain that spreads from the chest to the back, neck, jaw, upper belly, or one or both shoulders or arms. The left shoulder and arm are more commonly affected. See a picture of areas that may be affected by chest pain.
  • Dizziness, lightheadedness, or feeling like you are going to faint.
  • A fast, slow, or irregular heartbeat.
  • Note: If you have these symptoms, you should immediately chew one adult-strength aspirin (325 mg) or 4 low-dose aspirin (80 mg each) before emergency medical personnel such as paramedics arrive. This will help prevent a blood clot. Be sure to tell emergency personnel that aspirin has been taken.
• Any loss of function. You could be having a stroke. Signs of a stroke include:
  • Numbness, weakness, or inability to move (paralysis) of the face, arm, or leg, especially on one side of the body.
  • Trouble seeing in one or both eyes, such as dimness, blurring, double vision, or loss of vision.
  • Confusion, trouble speaking or understanding.
  • Trouble walking, dizziness, loss of balance or coordination.
  • Severe headache with no known cause.

Call your doctor immediately if you have any of the following symptoms of a new complication or one that is getting worse:

• Blurred or distorted vision; seeing floaters or flashes of light, large floating red or black spots, or large areas that look like floating hair, cotton fibers, or spiderwebs; or pain in the eyes
• A wound that won't heal or that looks infected

Call your doctor if:

• You are having high blood sugar levels persistently or frequently. Your treatment may need to be changed.
• Burning pain, numbness, or swelling in your feet or hands.
• Frequent bloating, belching, constipation, nausea and vomiting, diarrhea, and abdominal pain, which may indicate gastroparesis.
• Profuse sweating or reduced sweating.
• Feeling dizzy or weak when you sit or stand up suddenly.
• Leaking urine or having difficulty emptying the bladder completely.
• Erection problems or vaginal dryness.
• Difficulty knowing when your blood sugar is low (hypoglycemia unawareness).

Watchful Waiting

Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment. Watchful waiting for type 1 diabetes is not appropriate if you have any of the following symptoms.

• Persistent or frequent high or low blood sugar levels. Keeping your blood sugar levels as close to normal as possible can help slow the progression of your complication and prevent the development of others. You can keep track of your blood sugar levels with home tests and hemoglobin A1c tests at your doctor's office. The A1c test gives you an average of your blood sugar levels over the past 2 or 3 months.
• Symptoms of a new complication from diabetes. Early detection and treatment may reverse, stop, or at least slow the progression of the complication.
• Symptoms indicating that your complication from diabetes is getting worse. Prompt treatment may help prevent serious disability or death.

See your doctor if you have any of these symptoms.

Who To See

The specialist that you need to see depends on which complication you have. The following health professionals treat complications from type 1 diabetes:

• An ophthalmologist or optometrist can diagnose eye disease from diabetes. An ophthalmologist is the preferred specialist for retinal complications.
• A nephrologist treats kidney disease.
• A cardiologist or a vascular surgeon treats heart and/or circulation problems.
• A neurologist diagnoses and treats nerve damage.
• A podiatrist, pedorthist (a certified technician who can make special shoes or shoe inserts), or an orthopedic surgeon treats foot and ankle problems.
• A gastroenterologist treats stomach and intestinal problems.
• A urologist treats sexual and urinary tract problems.

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