High blood sugar level: If the patient's blood sugar level is more than 400 mg/dL, and the primary healthcare provider cannot see them right away. Very high blood sugar levels can be a sign of diabetic ketoacidosis or hyperosmolar hyperglycemic nonketotic syndrome, depending on the type of diabetes you have. Both of these conditions can be fatal if not treated promptly.

Large sores or ulcers on the feet or legs: If the patient has diabetes, a non-healing sore larger than 1 inch in diameter can be a sign of a potentially limb-threatening infection.

• Other signs and symptoms that merit immediate care are exposed bone or deep tissue in the wound, large areas of surrounding redness and warmth, swelling, and severe pain in the foot or leg.
• If left untreated, such a sore may ultimately require amputation of the limb.

Cuts or lacerations: Any cut penetrating all the layers of skin, especially on the legs, is a potential danger to a person with diabetes. Proper wound care, although important to anyone's recovery, is especially important in diabetics to assure good wound healing.

Chest pain: If the patient is diabetic, take very seriously any pain in the chest, particularly in the middle or on the left side, and seek medical attention immediately.

• People with diabetes are more likely than non-diabetic people to have a heart attack, with or without experiencing chest pain.
• Irregular heartbeats and unexplained shortness of breath may also be signs of heart attack.

Severe abdominal pain: Depending on the location, this can be a sign of heart attack , abdominal pain aortic aneurysm (widening of the large artery in the abdomen), diabetic ketoacidosis, or interrupted blood flow to the bowels.

• All of these are more common in people with diabetes than in the general population and are potentially life-threatening.
• Those with diabetes also get other common causes of severe abdominal pain such as appendicitis, perforated ulcer, inflammation and infection of the gallbladder, kidney stones, and bowel obstruction.
• Severe pain anywhere in the body is a signal for timely medical attention.

Self-Care at Home

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• If you or someone you know has diabetes, they would be wise to make healthful lifestyle choices in diet, exercise, and other health habits. These will help to improve glycemic (blood sugar) control and prevent or minimize complications of diabetes.
• Diet: A healthy diet is key to controlling blood sugar levels and preventing diabetes complications. If the patient is obese and has had difficulty losing weight on their own, talk to a healthcare provider. He or she can recommend a dietitian or a weight modification program to help the patient reach a goal.
• Eat a consistent, well-balanced diet that is high in fiber, low in saturated fat, and low in concentrated sweets.
• A consistent diet that includes roughly the same number of calories at about the same times of day helps the healthcare provider prescribe the correct dose of medication or insulin.
• It will also help to keep blood sugar at a relatively even level and avoid excessively low or high blood sugar levels, which can be dangerous and even life-threatening.
• Exercise: Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure , blindness, and leg ulcers.
• As little as 20 minutes of walking three times a week has a proven beneficial effect. Any exercise is beneficial; no matter how light or how long, some exercise is better than no exercise.
• If the patient has complications of diabetes (eye, kidney, or nerve problems), they may be limited both in type of exercise and amount of exercise they can safely do without worsening their condition. Consult with your health care provider before starting any exercise program.
• Alcohol use: Moderate or eliminate consumption of alcohol. Try to have no more than seven alcoholic drinks in a week and never more than two or three in an evening. One drink is considered 1.5 ounces of liquor, 6 ounces of wine, or 12 ounces of beer. Excessive alcohol use is a known risk factor for type 2 diabetes. Alcohol consumption can cause low or high blood sugar levels, nerve pain called neuritis, and increase in triglycerides, which is a type of fat in our blood.
• Smoking: If the patient has diabetes, and you smoke cigarettes or use any other form of tobacco, they are raising the risks markedly for nearly all of the complications of diabetes. Smoking damages blood vessels and contributes to heart disease, stroke , and poor circulation in the limbs. If someone needs help quitting, talk to a healthcare provider.
• Self-monitored blood glucose: Check blood sugar levels frequently, at least before meals and at bedtime, and record the results in a logbook.
  1. This log should also include insulin or oral medication doses and times, when and what the patient ate, when and for how long they exercise, and any significant events of the day such as high or low blood sugar levels and how they treated the problem.
  2. Better equipment now available makes testing blood sugar levels less painful and less complicated than ever. A daily blood sugar diary is invaluable to the healthcare provider in seeing how the patient is responding to medications, diet, and exercise in the treatment of diabetes.
  3. Medicare now pays for diabetic testing supplies, as do many private insurers and Medicaid.