Hi there, Thank you for choosing HCM for your query. As you mentioned that your daughter is a type 1 diabetic and has had pain in the right side of her abdomen which is shooting up alongwith vomiting 3 times. I am assuming that you had a blood ketone strip test done and her ketones have gone down from 5.6 and 1.0, probably after giving a bolus dose of insulin. The character of pain that you are describing is usually seen in gall bladder stones or cholecystitis. Diabetics are more prone to developing gall stones. But there are other reasons for abdominal pain in type 1 diabetics which are much more common like if she is in diabetic ketoacidosis or pancreatitis. Children who have diabetes are also more prone to infections, and this type of pain can also be seen in pneumonia associated with pleuritis. I would suggest you to discuss her current situation with your daughter s endocrinologist if you haven t already done so. Also, since her ketones are still at a 1.0 and she is continuing to have abdominal pain or if she is still having vomiting or is not able to keep fluids down or her blood sugar remains high, then she needs to go to the ER or see her endocrinologist immediately. Hope this helps. Best wishes for you and your daughter. Regards, Dr. Sumeet.