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What to do if…
your blood sugar or ketones are very high and you feel sick

Produced and maintained by PanicStation.org Published: Last reviewed: Editorial policy USA guide

Short answer

Arrange urgent medical assessment now. Go to an emergency room if your ketones are high while you feel sick, your blood sugar stays at 300 mg/dL or above, or you have vomiting, trouble breathing, confusion, unusual drowsiness, fruity-smelling breath, or difficulty keeping fluids down; call 911 if symptoms are severe or safe transport is not available.

Do not do these things

  • Do not exercise to try to lower the reading.
  • Do not stop insulin unless a healthcare professional tells you to.
  • Do not guess at an extra insulin or diabetes medication dose outside your written sick-day or correction plan.
  • Do not wait for another reading if you are confused, struggling to breathe, repeatedly vomiting, becoming hard to wake, or getting worse quickly.
  • Do not drive yourself if you feel weak, faint, drowsy, confused, or unable to concentrate.
  • Do not spend time troubleshooting equipment before arranging urgent care.

What to do now

  1. Arrange immediate emergency assessment. Call 911 for severe symptoms, reduced alertness, breathing difficulty, rapid deterioration, or when no one can take you safely; otherwise, ask someone to take you to an emergency room now.
  2. Tell the dispatcher or emergency staff that your blood sugar or ketones are very high and that you feel sick. Mention vomiting, breathing changes, confusion, drowsiness, stomach pain, or fruity-smelling breath.
  3. If it will not delay care, note your latest blood sugar and ketone readings, the times they were taken, your symptoms, and your most recent insulin or diabetes medication doses.
  4. Continue insulin only as directed by your existing sick-day or correction plan while help is being arranged. Do not stop it or improvise a larger dose.
  5. If you use an insulin pump, make a quick check for disconnected or kinked tubing, leaking insulin, an empty reservoir, or a loose infusion site. Do not delay emergency care to fix or investigate the pump.
  6. If you are fully awake, can swallow safely, and are not repeatedly vomiting, take small sips of water while waiting for transport or emergency help.
  7. Ask someone to stay with you. Bring your medicines, insulin or pump supplies, glucose and ketone equipment, identification, and recorded readings if they are easy to collect.

What can wait

You do not need to identify the cause, redesign your diabetes routine, plan future meals, replace every supply, contact your insurer, or make long-term treatment decisions now. These tasks can wait until you have been medically assessed and are stable.

Important reassurance

Seeking emergency help for very high blood sugar or ketones while feeling sick is a proportionate response. Diabetic ketoacidosis and other severe high-blood-sugar emergencies require prompt treatment, and emergency clinicians can assess and treat them.

Scope note

This guide covers immediate first steps only. Later medication changes, detailed pump troubleshooting, and future sick-day planning may require help from your diabetes care team.

Important note

This is general medical information, not a diagnosis or a substitute for emergency assessment or advice from your healthcare team. Call 911 for severe symptoms, reduced alertness, breathing difficulty, or rapid deterioration.

Additional Resources

Closely connected guides that may be useful during the same situation or its immediate aftermath.

About this guide

This guide was produced and is maintained by PanicStation.org using its published editorial process. Official and specialist sources are checked where relevant, and AI-assisted tools may be used for drafting, organisation, and consistency checks. The site operator remains responsible for publication, revision, and removal decisions.

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