When to Go to Hospital
Reviewed by CDE Mehandi Sharma · Updated
Deciding when to stop managing at home is genuinely difficult, particularly at two in the morning. Having the thresholds written down removes the judgement call.
Go for emergency care immediately if there is:
- Trouble breathing, or heavy and rapid breathing.
- Breath that smells sweet or fruity.
- Ketones present, especially more than trace amounts.
- Vomiting that prevents keeping any fluid down for more than four hours.
- Blood sugar staying at 300 mg/dL or above despite correction.
- Blood sugar below 60 mg/dL that will not come up.
- Drowsiness, confusion, or difficulty rousing someone.
- Inability to keep food down for a day, or fever above 101°F for a day.
Take your glucose meter and strips, ketone strips, all your insulin and a written list of doses, and your record of the last day's readings. That record genuinely changes the treatment you get.
Tell the emergency team three things immediately: that the person has Type 1 diabetes, what insulin they take, and when the last dose was given. In a busy hospital that information may not otherwise reach the right person quickly.
One thing not to do: do not wait it out overnight hoping it improves by morning. DKA in Type 1 progresses in hours, and the outcome depends heavily on how early treatment starts.