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Dr. Andrew Rynne

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Suggest treatment for vomiting in a diabetic

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 2850 Questions

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Posted on Tue, 17 Apr 2018 in Diabetes
Question: My friend is insulin dependent diabetic. Her sugar level just now was 189. She has been vomiting since about 6 or 7 o'clock (every 1 - 2 hrs.) I am afraid to go to sleep. I am afraid her sugar level will spike or bottom out.
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Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
She should be seen now.

Detailed Answer:
Hello and welcome,

You are right to be concerned about going to sleep with this situation.

The infection and stress of vomiting can elevate the blood sugar. While the abnormally high sugar level is not in itself the problem, it is indicative that her body is having trouble, and it is unlikely to get under control without getting the vomiting under control.

In addition, I am concerned about whether the vomiting is the cause or result. She could be having diabetic ketoacidosis.

Also, dehydration and potassium losses from vomiting can pose a bigger problem for someone with Type I diabetes.

I recommend you take her in to the ER. In the ER they will do a few different things (or should do):
assess her vitals (blood pressure, pulse) which help to show how stable she is
serum blood sugar
metabolic panel (electrolytes which include potassium, sodium, anion gap, etc)
check urine for sugar and ketones

They will give her an IV for fluid rehydration, and depending on her situation, this should also include some glucose too. I know that sounds counter productive, but in a situation like this you don't want to just bring the sugar level down with insulin.

They will also give her potassium and other electrolytes as needed.

They may give her an antiemetic (to help stop vomiting) if the dr. thinks the cause of the vomiting is from an infection rather than from ketoacidosis.

So -- take her in now! You are right to take action now.

Please let me know how she is doing after she has been evaluated and treated.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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