Type 2 Diabetes: Living With Complications: When To Call A Doctor

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When to Call a Doctor

Call 911 or other emergency services immediately if you:

• Lose consciousness or become very sleepy unexpectedly. You may have low blood sugar, called hypoglycemia. While you wait for emergency help, follow:
  • Emergency care for low blood sugar for people taking insulin.
  • Emergency care for low blood sugar in people taking only oral diabetes medicine.
• Are drowsy, confused, and breathing fast, and your breath smells fruity or like nail polish. You may have high blood sugar, called hyperglycemia. A life-threatening condition called diabetic ketoacidosis could be present.
• Have new or sudden vision loss. You may have a retinal detachment or bleeding within the eye.
• Have 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 1 adult-strength aspirin (325 mg) or 4 low-dose aspirin (80 mg each) before emergency medical personnel such as paramedics arrive. This can help to prevent a blood clot. Be sure to tell emergency personnel that you took aspirin.
• Have any loss of function. You could be having a stroke. Signs of a stroke include:
  • Numbness, weakness, or inability to move (paralysis) 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 or trouble speaking or understanding.
  • Trouble walking, dizziness, or loss of balance or coordination.
  • A severe headache with no known cause.

Call your doctor immediately if you have any of the following symptoms of a new or worsening complication:

• 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.
• Have burning pain, numbness, or swelling in your feet or hands.
• Have frequent bloating, belching, constipation, nausea and vomiting, diarrhea, and belly pain, which may indicate gastroparesis.
• Have profuse sweating or reduced sweating.
• Feel dizzy or weak when you sit or stand up suddenly.
• Have trouble sensing when your bladder is full or trouble emptying your bladder completely.
• Have erection problems or vaginal dryness.
• Have trouble knowing when your blood sugar is low (hypoglycemia unawareness).

Who to See

Depending on your complication, you may need to see one or more of the following health professionals:

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

Last updated:	August 09, 2007
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Matthew I. Kim, MD - Endocrinology & Metabolism
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC