Diabetes & Hyperglycemia Referral Guidelines

Clinical Findings

  • Increased thirst and urination
  • Weight loss
  • Vomiting (DKA)
  • Lethargy (DKA)
  • Deep Respirations (DKA)

Referral Timeframe

URGENT: Call MD on-call to discuss and start treatment. If symptomatic, call Emergency Dept. (911)
On-Call Phone #
Day: (512) 628-1830
After Hours: (512) 323-5465

Pre-Referral Workup

  • Finger Stick Blood Glucose
  • Urinalysis for KETONES and glucose
  • If NOT acutely ill, consider STAT chemistry panel to determine disposition (direct admit vs. ER)

Referral Requirements

  • If fasting BG over 126 mg/dl or a random BG 2 hour or OGTT over 200 mg/dl, then call is URGENT
  • FOR ALL NEW DIAGNOSES of Diabetes Mellitus, please inform phone concierge call is URGENT
  • DKA is likely if patient is vomiting, lethargic or abnormal respirations. Send immediately to Emergency Department AND notify Endocrine MD on-call.

Key Facts to Remember

  1. Signs of DKA warrant an urgent call and immediate referral to Emergency Department (call 911)
    • Vomiting, Deep Respirations, Altered Level of Consciousness – Signs of Diabetic Ketoacidosis – Refer to Emergency Department (911) with call to PICU/Endocrine – Day: (512) 628-1830 or After Hours: (512) 323-5465
    • Large Ketones in Urine
    • CO2 < 15 on chemistry panel
  2. If Diabetes is clinically apparent, then a separate fasting glucose or 2 hour OGTT are not required, please call immediately.
  3. Obesity before age 5 is considered Early Onset and may indicate a genetic cause of the obesity.