Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency medical help now if you or someone with diabetes has signs of possible DKA, particularly:
Fast, deep, or difficult breathing
Repeated vomiting or inability to keep fluids down
Confusion, unusual drowsiness, collapse, or difficulty waking
Fruity-smelling breath with worsening illness
High ketones or ketones in the emergency range on the testing device
Symptoms of DKA while taking an SGLT2 inhibitor, even without high glucose
Call emergency services.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Follow your sick-day plan and seek urgent diabetes advice if glucose remains high despite correction treatment, ketones are rising, a pump problem cannot be fixed, or you are unsure how to continue insulin safely.
Contact your usual diabetes service sooner if you are having repeated ketones, frequent pump failures, trouble obtaining insulin, or difficulty taking treatment as planned.
3
Does any of this apply?
Book an appointment
Routine follow-up is appropriate after recovery to review what triggered the episode and reduce the chance of another one.
The article also says
Do not drive yourself if you are confused, very drowsy, or severely unwell.
Every sign above is quoted from the sofidex article on Diabetic ketoacidosis. If you are not sure, err upward — it is always reasonable to be checked.