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Draft: not yet reviewed by a clinician

Use this page to prepare questions for your care team. It does not replace their advice. Your own targets and doses come from your nephrologist, diabetes team and renal dietitian.

Wallet cards

In short

These four cards fit in a wallet. The first says when to get help. The second tells paramedics and hospital staff what they need to know if you cannot speak for yourself. The third and fourth hold your own numbers and sick-day plan, written in by you and your care team. Paper still works when a phone is flat, locked or lost.

How to print and use them

  1. Print this page (Ctrl+P, or Share → Print on a phone). Each card prints at credit-card width, 85.6 mm (3.4 in).
  2. Cut along the border. Fold or tape two cards back to back, and cover them with clear tape to keep them dry.
  3. Fill in the blanks in pen with your care team, not from this handbook. Leave a line blank rather than guess.
  4. Keep one card with your glucose tablets and one in your wallet. Give a copy to the people you live with.
  5. Wear a medical ID bracelet or necklace as well: it tells others you have diabetes and need care right away (NIDDK). Many phones can also show medical information on the lock screen.
  6. Update the cards after any change to your stage, your treatment or your medicines.

Card 1: get help

The same card as on Get help now.

Kidney disease + type 1 diabetes: get help

Call 911 (112 EU · 999 UK · 000 Australia): chest pain · can't breathe or lie flat · fainting, very slow or irregular pulse · lab potassium 6.5 mmol/L or more · stroke signs (note the time) · a low I can't treat: glucagon, turn me on my side, call 911 · blood ketones 3.0 mmol/L or more, or ketones with vomiting · fistula bleeding not stopped after 10–15 min of firm pressure · fever with confusion or a racing pulse · after a transplant, fever with shaking chills · blood pressure 180/120 or higher with a sudden severe headache, trouble breathing, chest, belly or back pain, numbness or weakness, a sudden vision change or trouble talking (call, do not wait to measure again)

Call my team now or today: potassium 6.0–6.4 mmol/L · ketones 1.6–2.9 mmol/L (now; emergency room if no answer) · vomiting, diarrhea or not eating · cloudy PD fluid (keep the bag) · no fistula buzz · missed dialysis · fever over 100 °F (37.8 °C) after a transplant · lows that keep coming back · blood pressure 180/120 or higher after resting 5 minutes · weight gain above my alarm weight

Kidney team: ____ Diabetes team: ____

Dialysis unit or transplant center: ____

My fluid limit: __ My alarm weight: __

Card 2: for paramedics and hospital staff

I have type 1 diabetes and chronic kidney disease

Name: ____ Date of birth: ______

If I am confused, sweaty, drowsy or acting strangely, I may have low blood glucose. Check my glucose. If I can swallow, give me sugar. If I cannot, give glucagon, turn me on my side and call 911.

Kidney: ☐ CKD stage _ ☐ hemodialysis ☐ peritoneal dialysis ☐ kidney transplant (year _)

☐ Fistula or graft in my ______ arm: no blood pressure cuff, blood draw or IV in this arm

☐ I use icodextrin (Extraneal) PD fluid: some glucose meters read falsely high. Use a glucose-specific method or a lab test.

☐ I take anti-rejection medicines: do not stop them.

☐ Insulin pump ☐ CGM ☐ Glucagon in my bag

Allergies: ____

Emergency contact: ____ Phone: ______

Kidney team: __ Diabetes team: ____

Why each line is there:

  • Lows: a severe low needs glucagon and a 911 call; the person should be turned on their side, because they may vomit as they wake, and fed only when they can swallow (NIDDK; ADA 2026 §6; glucagon instructions).
  • Access arm: blood pressure cuffs, blood draws and IVs can damage a fistula or graft (NKF).
  • Icodextrin: this PD fluid makes some glucose meters read falsely high. Extra insulin given for a false high can cause a severe low, coma or death (MHRA), and a real low can be missed. The false readings can last up to two weeks after stopping the fluid (Extraneal label).
  • Transplant: without anti-rejection medicine, your immune system may attack the new kidney (NIDDK).

Card 3: my numbers

Your team writes these in. They are your limits, not the typical starting points in this handbook.

My numbers (from my care team, date __)

Potassium: under __ mg a day · Sodium: under ____ mg a day

Phosphorus: under __ mg a day · Protein: about ____ g a day

Fluid: __ a day (counting soups, ice and gelatin) · Carbohydrate: ____ g per meal

Dry or target weight: __ · Call if I gain more than _ in ___

Blood pressure goal: under __ / ____

Latest labs (date __): eGFR _ UACR potassium ___

My insulin plan is written by my diabetes team. I do not change it from this card.

The app can hold the same numbers and warn you when a day goes over them (Targets and warnings).

Card 4: my sick-day plan

KDIGO asks that any medicine paused during an illness comes with a clear plan for when to restart it, written down, because forgetting to restart is a common harm (KDIGO 2024, practice points 4.3.2–4.3.3). Ask your team to fill this card in.

My sick-day plan (filled in by my care team, date __)

When I am vomiting, have diarrhea or cannot eat or drink:

Check glucose every __ hours and ketones every ____ hours.

Medicines to pause: ______

Restart them when: ______

Keep taking insulin, even if I am not eating. Call __ if ketones are 1.6 mmol/L or more.

Extra fluid allowed while ill: ______

Why "keep taking insulin": stopping or skipping insulin while ill can lead to DKA, so the NHS advises "do not stop taking insulin, even if you're not eating" (NHS; ADA 2026 §6). Your team tells you how to adjust it. More on illness: Sick days.

Ask your care team

  1. Will you fill in my numbers card and my sick-day card at this visit?
  2. Which arm, if any, should never be used for blood pressure or blood tests?
  3. If I use icodextrin, which glucose meters are safe with it?
  4. Who should I call out of hours, and what number goes on the card?

Sources

Not yet reviewed by a clinician. Facts and sources last checked 2026-10-06.