I haven’t been in the position yet, haven’t played with the in flight failures or run low on fuel but do you get ATC dialogue options to declare an emergency and expedite an immediate landing type thing?
No, not implemented.
I was running out of fuel because of heavy nosewind and decided to divert. Just added the new flightplan, requested IFR and flown to my alternate. On regular engine shutdown I was only minutes away from low fuel shutdown.
Unfortunatey not (yet)
Even squaking 7700 is ignored
Maybe, vatsim does, but I’m not sure.
I’m ready to declare an emergency every time I launch the sim! 
PF3 (an ATC add-on) supports declaring emergencies. I have the add-on and like it, but I haven’t tried declaring an emergency. You can get a try before you buy demo though, so you can check it out.
Yeah it’s a shame it’s not implamented, Flight Unlimited 2, by Looking Glass had this feature and they would vector you to the nearest airport as well as clearing traffic.
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