Type 2 Diabetes In Children: 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 in people taking only oral diabetes medicine
  • Emergency care for low blood sugar in a child who takes insulin
• 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 or 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 oral diabetes medicines or after 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 doctor observe your child's symptoms or condition without using medical treatment. Watchful waiting is not appropriate if:

• You think your child may have symptoms of type 2 diabetes. A simple blood test is all that is needed to determine whether your child has the disease.
• Your child is overweight and gets little or no exercise. He or she is at risk for developing diabetes. Early detection and treatment for type 2 diabetes can prevent or delay complications from the disease.
• You have been told that your child has prediabetes. This condition can lead to type 2 diabetes. If your child eats a healthy diet and exercises regularly, he or she may not develop diabetes.

Who To See

Most doctors can diagnose diabetes. After your child has been diagnosed, your doctor will work with you to develop a treatment plan that fits your child's needs. Health professionals who may be involved in the treatment of children with type 2 diabetes include:

• A pediatrician, family medicine doctor, or general practitioner.
• A nurse practitioner or physician assistant.
• A pediatric endocrinologist.
• A certified diabetes educator (CDE). A CDE is a registered nurse, dietitian, doctor, pharmacist, or other health professional who has special training and experience in caring for people with diabetes.
• 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 treatment.
• An exercise specialist, to help your child and family plan a program of regular physical activity.

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

Last updated:	July 28, 2008
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Stephen LaFranchi, MD - Pediatrics and Pediatric Endocrinology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC