When to See a Doctor Urgently

Most of diabetes is managed slowly, over months. A small number of things are not, and knowing which is which prevents both dangerous delays and unnecessary panic.

Go now — the same day, or to an emergency department

• Vomiting repeatedly, or unable to keep fluids down. This is the clearest single rule during illness.
• Blood ketones above 3.0 mmol/L — a medical emergency. Between 1.5 and 3.0, contact your care team straight away.
• Deep or fast breathing, breath smelling fruity, drowsiness or confusion. These suggest diabetic ketoacidosis.
• A severe low — unable to treat it yourself, or someone found unresponsive.
• A foot wound that is spreading, hot, or has blackened or foul-smelling tissue.
• Sudden vision change, particularly loss of vision in part of the field.
• Chest pain, breathlessness, or one-sided weakness or facial droop. Heart attack and stroke are nearly twice as likely with diabetes, and can present unusually.

Contact your team within a few days

• Readings persistently high or low despite following your usual plan
• Repeated lows, especially at night
• A new foot ulcer, numbness or tingling
• Starting a steroid or another new medicine

See also the sick-day rules for what to do while you decide.