My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Diabetes
Diabetes is a condition that makes it difficult for your body to regulate blood sugar levels. Managing diabetes means adopting healthy behaviors and taking medication as directed to stay healthy and prevent complications.
Diabetes: Managing Acute High Blood Sugar [Read/Print full article]
Overview
.
With type 2 diabetes, high blood sugar often develops gradually over time. However, high blood sugar can develop quickly in some people, especially in people with type 1 diabetes. Treatment of acute high blood sugar is mostly needed in type 1 diabetes.
In the short term, high blood sugar can cause dehydration and you may or may not have other symptoms. Over time, high blood sugar can lead to diabetes complications by gradually damaging blood vessels, organs, and nerves.
Monitoring your blood sugar with your glucose meter on a regular basis helps alert you to high blood sugar levels so that you can take action. When you have high blood sugar, it is important for us to discuss a plan for bringing your blood sugar into the target range. Early treatment prevents mildly high blood sugar from becoming very high blood sugar, which requires urgent medical care. Early treatment also helps prevent complications. Talk with us about what blood sugar level is too high for you.
Symptoms
.
Monitoring your blood sugar with your glucose meter is the best way to know if your blood sugar is high. You may or may not experience symptoms. If you do have symptoms, they may include:
- Extreme tiredness
- Extreme thirst
- Frequent urination, especially at night
- Blurry vision or a change in vision
- Increased hunger
- Unintentional weight loss
- Sores or cuts that heal slowly
- Numbness or tingling in your feet
- Frequent infections of skin, gums, bladder, or vagina
You need immediate medical care if your symptoms are more severe. Symptoms of dangerously high blood sugar include:
- Difficulty waking up
- Confusion
- Moderate to severe abdominal pain
- Dizziness or weakness when sitting or standing
- Rapid, deep breathing
- Strong, fruity breath odor (similar to nail polish or acetone)
Call us immediately or come to the nearest Emergency Room if you have any of these symptoms. These are possible signs of severe dehydration and an emergency condition called diabetic ketoacidosis (DKA). With diabetic ketoacidosis, there is not enough insulin in the body, resulting in very high blood sugar levels and changes in the metabolism. People with type 1 diabetes can experience DKA, and some people with type 2 diabetes can develop it. Ketoacidosis is usually caused by not taking enough insulin or having a severe infection or illness. The best way to prevent DKA is by regularly monitoring your blood sugar and taking immediate action if your blood sugar is high.
Causes and Prevention
.
Causes
High blood sugar can result from:
- Eating more carbohydrate than usual
- Being less active than usual
- Having an illness or infection
- Stress
- Not taking enough diabetes medication or insulin
- Not drinking enough or being dehydrated
Prevention
You can prevent frequent high blood sugar levels by caring for your diabetes: eating healthy foods, being physically active, taking your medication, and monitoring your blood sugar. Talk with us about your blood sugar targets and contact us if you notice frequent or persistent high blood sugar readings so we may adjust your treatment plan.
Treatment
.
Check your blood sugar as often as you and your physician decide. Watch for trends or patterns. Are your blood sugar readings consistently high all day or high only at certain times of the day?
Stay hydrated. Drink plenty of water or noncaffeinated, sugar-free beverages to keep you hydrated. High blood sugar causes dehydration, which can become serious.
Take your diabetes pills or insulin as prescribed. Many people struggle with consistently taking medications. Develop a plan to take your diabetes pills or insulin as prescribed.
Eat a healthy diet. Limit sweets and choose moderate portions of carbohydrate foods. Space meals and snacks in a regular pattern throughout the day.
Be physically active at a comfortable pace. When your blood sugar is high, we do not recommend strenuous activity because it can further increase blood sugar levels. If you have type 1 diabetes and your blood sugar is above 250 mg/dL, check your urine for ketones using the ketostix prescribed by us. Having ketones in your urine means your body needs more insulin. If there are moderate or high ketones, do not exercise and contact us right away to discuss your treatment.
Contact us if your blood sugar readings are persistently high. We will discuss adjusting your medication and other treatments. Call us right away for urgent treatment if you:
- Feel confused or very lethargic.
- Have ketones in your urine.
- Have symptoms of dehydration, such as extreme thirst, dry mouth, and cracked lips, or have not urinated for 8 hours.
Your Care with Me
.
We urge you to call if your blood sugar gets:
- Very low (typically under 70 mg/dL or a target we have set for you).
- Very high (typically over 300 mg/dL or a target we have set for you).
And especially if you have symptoms such as:
- Dizziness.
- Cold sweats.
- Shortness of breath.
- Seizures related to low blood sugar.
- Excessive thirst and/or urination.
If you are pregnant and your blood sugars get very low (hypoglycemia), call 911.
As part of your routine care, I will order lab tests to screen for diabetes at the appropriate time, based on your risk factors. If you have prediabetes, you can enroll in the prediabetes class without a referral for more information and support.
If we determine that you have diabetes, I will work with you to help manage it. We have a comprehensive program to help you live well with diabetes and maintain your health. I will refer you to a Diabetes Education class. You will be prescribed a glucose monitor, and you or your family will be trained to use it. We have online tools and classes to help you with physical activity, healthy nutrition, smoking cessation, and weight management.
I will likely prescribe medication. As we continue to monitor your blood sugar levels, blood pressure, and cholesterol levels, we will send you for follow-up tests and make adjustments as needed.
If you have difficulty getting your blood sugar under control, I may recommend that you work closely with a Diabetes Care Manager to help you achieve ideal blood sugar, blood pressure, and cholesterol levels. If you have diabetes and you are working with a Care Manager, you may call him or her directly. If you are interested in a referral to this program, please contact me.
Diabetes and Pregnancy
If we know about your diabetes when you become pregnant, I may help you enroll in the Kaiser Regional Perinatal Nursing Services Program. They have someone on call at all times, and you should call them for advice: 1-800-439-8376.
.
.
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
- For nonurgent questions or concerns, you can e-mail me using this site. You can also book an appointment online to see me in person.
- If your concerns are immediate, or you simply prefer to use the telephone, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you.
.
How We Coordinate Your Care
.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
If you come to an office visit
- At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need.
- At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
- To help you prepare for your visit, please see additional details under Office Visit.
If I prescribe medications
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
- Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
- Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If I refer you to a specialist
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
If you are due for preventive screenings or tests
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
.
Convenient Resources for You
.
My goal is to provide high quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
Manage your care securely
- View and compose secure e-mail messages.
- Manage your prescriptions and schedule appointments.
- View your past visits and test results.
- View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
- Read about causes, symptoms, treatments and procedures.
- Find interactive health tools, videos, and podcasts to help you manage your condition.
- View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
- Locate health education classes and support groups offered at our medical center.
- Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
- View your Preventive Services to see whether you are due for a routine screening or updated immunization.
.
Related Health Tools:
Interactive Programs
- Manage diabetes with Care™ for Diabetes Manage diabetes with Care™ for Diabetes
Personal Logs and Diaries
- Diabetes Blood Sugar Log Diabetes Blood Sugar Log
- Diabetes Blood Sugar Log (Spanish) Diabetes Blood Sugar Log (Spanish)
Videos
- Insulin for Diabetes Insulin for Diabetes
- Insulina para la diabetes (Spanish) Insulina para la diabetes (Spanish)
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.