Disabled type 1 Diabetic

Answer by Dr. Albana Greca Sejdini, MD, MMedSc, Family Physician, IDF Fellow

Hello Robert,

With the history you describe, I think the most important step is to make sure that one clinician or diabetes team is looking at the whole picture rather than treating each problem separately.

Two Comas Need to Be Explained Clearly

In type 1 diabetes, coma can occur with severe hypoglycemia, diabetic ketoacidosis, or other serious illness. I would not assume that your insulin or another treatment caused the episodes without reviewing what your glucose, ketones, electrolytes and other tests showed at the time.

Severe hypoglycemia can cause confusion, seizure, loss of consciousness and coma. Recurrent severe hypoglycemia is an urgent reason to review insulin doses, meal timing, glucose monitoring and hypoglycemia awareness.

Your Kidney, Eye and Blood Pressure Problems Matter Together

Kidney disease, hypertension and diabetic eye disease can influence how your diabetes should be managed. They also affect medication choices, blood pressure goals and the intensity of glucose control.

Diabetic retinopathy is more likely to progress when glucose and blood pressure remain uncontrolled, so eye care and diabetes care should be coordinated. :chatgpt-content-reference{index="1"}

I would also want to know your kidney function, including creatinine, estimated glomerular filtration rate (eGFR) and urine albumin, because kidney impairment can change insulin needs and increase the risk of hypoglycemia.

Would a Second Opinion Be Reasonable?

Yes. If you feel that important information is not being explained or that several specialists are not communicating with one another, asking for a second opinion is reasonable.

Ideally, this would include an endocrinologist or diabetes specialist who can review:

• your insulin regimen;


• CGM or glucose-meter records;


• the circumstances around the two coma episodes;


• HbA1c and glucose variability;


• kidney function and urine albumin;


• blood pressure treatment;


• eye records and previous procedures;


• neuropathy, foot problems and circulation;


• all current medicines.

Bring Your Records With You

A second opinion is most useful when the new clinician can see your actual medical records rather than trying to reconstruct the history from memory.

I would ask for copies of your recent laboratory results, discharge summaries, eye-surgery reports, kidney tests, medication list and any CGM or glucose records.

Our blood glucose target guide can help you understand common treatment goals, but your targets may need to be individualized because of your medical history.

Ask About Preventing Another Severe Low

If either coma was caused by hypoglycemia, prevention should become a major part of your treatment plan.

Ask whether continuous glucose monitoring, low-glucose alarms, insulin adjustment, glucagon availability and education for family members or caregivers would help reduce your risk of another severe episode.

Our low blood glucose guide explains common causes and warning signs.

My Advice

With your history, I would not try to manage this through occasional laboratory numbers alone. You need a coordinated review of your type 1 diabetes, kidney function, blood pressure, eye disease and the causes of the two coma episodes.

If you do not feel confident that your current team is providing that coordination, seeking a second specialist opinion is a reasonable next step. Bring your records so the new clinician can make decisions from the full medical history.

Related Pages

• Low Blood Glucose: Causes and Warning Signs


• Blood Glucose Targets for Adults With Diabetes


• Diabetes and Leg Pain

References

• ADA Standards of Care 2026: Hypoglycemia and Hyperglycemic Crises


• ADA Standards of Care 2026: Comprehensive Medical Evaluation


• ADA Standards of Care 2026: Retinopathy, Neuropathy and Foot Care