I have type 2 diabetes treated with pills along with peripheral neuropathy in my feet which is also being treated, and today my mid-afternoon blood sugar read 563 mg/dl [31.2 mmol/L]. Should I go to the ER with the blood glucose this high?

I have a couple of comments. It really is inappropriate to use this forum for an acute issue. If you have high glucose readings today, you should seek advice from your own health care team today.

Having said that, folks with type 2 diabetes do not usually have problems with excessive ketone formation. Some of meters will “remind” you to check for ketones, but that really is for the folks with type 1 diabetes. While it sounds like your overall diabetes control is not the best as you’d like, you can hardly ever go wrong by drinking water and assuring hydration when you have higher glucose readings. If you are not under the care of a diabetologist, you might wish to ask for a referral.

DS
Additional comments from Dr. Stuart Brink:

It sounds like you should be working very closely with your diabetes team especially with the nurses and dietitians. A lot would depend upon how often you are checking blood glucose levels, what kind of meal plan you have, how well you can follow these suggestions, etc. If you are symptomatic with such high sugar levels, certainly you should seek some further detailed advice.

SB