Diabetes: when to see a doctor
Your diabetes educator and/or doctor should be your first port of call if you have questions about diabetes.
An emergency call will be necessary if:
- Your blood-glucose level is above 13.9mmol/l for more than 24 hours.
- Your ketone levels are high and fail to go down after several hours of treatment.
- You’re losing weight.
- You’re experiencing diarrhoea or vomiting and can’t keep any food down.
- You develop abdominal pain.
- You notice a change in your breathing.
- You have a high fever that won’t come down.
- You or a family member finds that you’re confused or sleepy and difficult to wake up.
These are all signs of diabetic ketoacidosis or hyperglycaemic hyperosmolar state (anextremely high blood-glucose level without the presence of ketones). If you can’t reach your doctor and your situation isn’t getting better, you may have to call an ambulance or have someone take you to a hospital emergency room.
This is a medical emergency that’s relatively easy to treat in its early stages, but more difficult to manage (and sometimes even fatal) if not treated as a matter of urgency.
Other changes in your health that need attention
See your doctor if:
- You’re too sick to check your blood-glucose levels at least every 4 hours. Don’t stop taking your insulin or medicine.
- You notice you have a blister, sore or other wound on your foot and it’s getting larger or seems infected.
- You have changes in vision.
- You start to notice that, despite all your efforts, your blood glucose isn’t under control.
Symptoms you should never ignore
If you have diabetes, there are some symptoms you should never ignore. These include:
Signs of low blood sugar (hypoglycaemia)
- Feeling dizzy, woozy, confused or losing consciousness.
- Slurring words.
If you experience any of these symptoms, eat a boiled sweet, a glucose tablet or a spoonful of honey, and call for emergency medical help.
Signs of high blood sugar (hyperglycaemia)
Talk to your doctor if you’re experiencing any of the following:
- Urinating more frequently or with larger volumes, especially at night.
- Feeling thirsty frequently.
- Experiencing constant and/or extreme fatigue.
How to make the most of your doctor’s visits
If you’ve been diagnosed with diabetes, your health team will give you a scheduled programme to follow. This will indicate when you should be visiting the different health practitioners and when you’ll have to get certain blood tests done.
In the interim, it’s important to write down any questions that occur to you as you manage your condition. Take these questions along with you when you next visit your doctor or other health practitioner.
Here’s a list of some of the questions you might want to ask:
- How often do I need to check my blood-glucose levels and what should they be?
Also make sure you understand HOW to test your glucose levels and how to use a blood-glucose meter that you’re comfortable with.
- I know that, as a person with diabetes, I need to take good care of my feet. What does this entail?
Ask your doctor to refer you to a podiatrist, who will do the necessary training regarding foot care and good footwear.
- I know I have to exercise to help control my blood glucose. Can I do any type of exercise I like?
Talk to your doctor about a safe exercise programme for you. A biokineticist will be of great help here. Also ask your doctor for more information about checking your blood-glucose levels before and after physical activities, and how to adjust your insulin if necessary.
- What should I do to take could care of my eyes?
Ask your doctor to refer you to an ophthalmologist. You’ll need to get regular eye screenings.
- I know that, as a person with diabetes, I’m at risk for depression. Which signs should I be looking out for?
Depression can manifest itself in many different ways. Ask your doctor to refer you to a good psychologist and/or psychiatrist, if necessary.
See your doctor regularly – at least every 3-6 months. It’s important to build a trust relationship with this health practitioner, so that you’ll feel comfortable asking any questions related to your health (even “uncomfortable” ones about conditions such as erectile dysfunction or vaginal thrush).
Information supplied by Jeannie Berg, diabetes educator and Chairperson of the Diabetes Education Society of South Africa (DESSA), and reviewed by Dr Joel Dave (MBChB PhD FCP Cert Endocrinology), Senior Specialist in the Division of Diabetic Medicine and Endocrinology, University of Cape Town. August 2018.