Kenneth Bae, 45, who was sentenced to 15 years of hard labour for trying to overthrow the North Korean government, has diabetes and an enlarged heart.
His sister says he is now too weak to work.
The US government has appealed to North Korea to release Kenneth Bae.
Kenneth Bae (known in North Korea as Pae Jun-ho) was detained last year after entering North Korea as a tourist and sentenced in May this year.
He was said to have used his tourism business to form groups to overthrow the government.
Kenneth Bae’s sister, Terri Chung, said on Saturday he had recently been visited by a Swedish diplomat and that her brother was now in a hospital.
“We’re terribly worried about his health. I think it has been deteriorating,” Terri Chung told the KING5.com news website in the US.
North Korea has arrested several US citizens in recent years, including journalists and Christians accused of proselytism.
They were released after visits to Pyongyang by high-profile officials, including former presidents Bill Clinton and Jimmy Carter.
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