When Should You Seek Medical Attention for Diabetes?

If you or someone you know is not previously diagnosed with diabetes but experiences symptoms suggesting diabetes or causes concern, it's essential to schedule an appointment with a healthcare provider promptly. When making the appointment, please inform the operator about your diabetes concerns. They may arrange for blood sugar testing before the appointment.

If the patient is already diagnosed with diabetes, contact a healthcare provider immediately under the following circumstances:

• The patient is displaying symptoms of diabetes, indicating inadequate blood sugar control despite treatment.
• The patient consistently has high blood sugar levels (above 200 mg/dL), which can lead to complications.
• The patient frequently experiences low blood sugar levels (below 60 mg/dL), potentially indicating aggressive management or other underlying issues like kidney or liver problems.
• The patient sustains an injury to the foot or leg, no matter how minor, as even minor wounds can escalate in diabetes patients. Early detection and treatment of lower extremity issues, along with regular diabetic foot care, are crucial for preserving leg function and avoiding amputation.
• The patient has a mild fever (below 101.5°F), which could signal an infection. In diabetes patients, common infections may be more severe. Watch for symptoms that pinpoint the infection's location, such as painful urination, skin redness or swelling, abdominal pain, chest pain, or cough.
• The patient experiences nausea or vomiting but can retain liquids. The healthcare provider may need to adjust medications, so they may recommend an urgent office visit or an emergency department visit. Persistent nausea and vomiting can be signs of diabetic ketoacidosis, a potentially life-threatening condition, or other severe illnesses.
• The patient has a small non-healing sore or ulcer on the foot or leg, smaller than 1 inch, not discharging pus, and not exposing deep tissue or bone. Such sores can be evaluated in a healthcare provider's office as long as the patient does not have a fever, and blood sugar levels are stable.

When calling a healthcare provider, inform the operator that you or someone you know has diabetes and express your concerns:

• You will likely be referred to a nurse who will ask questions and provide recommendations based on the information you provide.
• Be ready for this conversation, and have a list of medications, medical conditions, medication allergies, and a blood sugar diary on hand when speaking with the nurse.
• The nurse may require this information to assess the urgency of the patient's condition and recommend appropriate treatment.

Diabetic Emergencies

The following situations can escalate into medical emergencies requiring a visit to a hospital emergency department.

1. The person experiencing a severe diabetic complication should be taken to the emergency department by car or ambulance.
2. A companion should accompany them to communicate with healthcare providers if the patient cannot do so themselves.
3. Bring a list of medical conditions, medications, medication allergies, and the blood sugar diary to the emergency department. This information will aid in diagnosing and treating the issue correctly.

The following are signs and symptoms of diabetic complications that warrant emergency care.

Altered mental status: Unusual behavior, lethargy, agitation, or forgetfulness could indicate very low or very high blood sugar levels.

1. If the person is a known diabetic, consider giving them about 6 ounces of fruit juice or cake icing if they can swallow normally. Avoid giving hard candy that might get stuck in the throat. Healthcare providers can prescribe glucose wafers or gels that dissolve under the tongue.
2. If the person doesn't wake up and behave normally within 15 minutes, call 911.
3. If the person is not a known diabetic, these symptoms could signal stroke, drug intoxication, alcohol intoxication, oxygen deprivation, or other serious medical conditions. Call 911 immediately.

Nausea or Vomiting: If the patient is known to have diabetes and cannot keep food, medications, or fluids down, they may have diabetic ketoacidosis, hyperosmolar hyperglycemic nonketotic syndrome, or another diabetes-related complication.

1. If the patient hasn't taken their latest insulin dose or oral diabetes medicine, do not administer it without consulting a medical professional.
2. If the patient already has low blood sugar levels, taking additional insulin or medication could further lower their blood sugar, potentially to dangerous levels.

Fever exceeding 101.5°F: If the primary healthcare provider cannot see the patient immediately, seek emergency care for a high fever if they have diabetes. Pay attention to other symptoms like cough, painful urination, abdominal pain, or chest pain.