Type 1 Diabetes: Children Living With The Disease: When To Call A Doctor

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When To Call a Doctor

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

• Unconscious or becomes very sleepy unexpectedly. 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 child’s breath smells fruity or like nail polish. Your child may have high blood sugar, called hyperglycemia. A life-threatening condition called diabetic ketoacidosiscould be present.

Call a doctor immediately if your child is vomiting and cannot keep down liquids and has a blood sugar of 250 mg/dL or higher.

Call a doctor if your child:

• Is sick for more than 2 days (unless it is a mild illness, such as a cold), and your child:
  • Has been vomiting or had diarrhea for more than 6 hours.
  • Has followed his/her 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 250 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 his or her blood sugar is low (hypoglycemia unawareness).
• Is having problems following the meal plan or getting physical activity, and you want help.

Watchful Waiting

Watchful waiting is a period of time during which you and your health professional study your health without using medical treatment. Watchful waiting is not appropriate for a child with type 1 diabetes if blood sugar levels are frequently high or low. His or her treatment may need changing. Keeping your child's blood sugar levels within a normal or near-normal range helps prevent high blood sugar emergencies and long-term complications, such as eye, kidney, heart, blood vessel, and nerve damage.

Who To See

Health professionals who may care for a child with type 1 diabetes include:

• A pediatrician, a family medicine doctor, or a general practitioner.
• A nurse practitioner or a physician assistant.
• A pediatric endocrinologist.
• A certified diabetes educator (CDE).
• A registered dietitian, to help develop a daily meal plan for your child and your family.
• A psychologist, to help with emotional or family issues that might affect your child's treatment.

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

Last updated:	January 19, 2007
Author:	Robin Parks, MS
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Alan C. Dalkin, MD - Endocrinology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC