Diabetic ketoacidosis remains the most important acute complication of diabetes mellitus, causing metabolic decompensation with an associated morbidity and mortality of 1–10%. Although levels of morbidity and mortality are falling with modern management protocols, a significant threat still remains. While DKA is most common in patients with type 1 diabetes mellitus, it should not be overlooked in patients with type 2 diabetes mellitus, especially in those who require insulin. In contrast to chronic management, acute complications often present to Acute Medicine rather than to specialist diabetes services. Prompt recognition, diagnosis, and treatment are therefore essential.
