Diabetes is one of the most common chronic diseases in the world, thus its complications have been studied and acknowledged as a critical aspect of modern medicine. When we talk about the most serious, acute, and life-threatening emergencies in these patients, hyperglycemic comas are the most common. This entity includes both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) in diabetic patients. Generally, patients will show features of insulinopenia, severe hyperglycemia, ketoacidosis, and hyperosmolality. Our objective was to look into the literature concerning diabetic ketoacidosis and particularly the diagnosis process and management. PubMed database was used for articles selection, papers were obtained and reviewed. Nowadays, diabetes is one of the most chronic diseases and thus its complications are seen more in the clinical setting. Diabetic ketoacidosis is one of the most dangerous side effects which is seen in the emergency department. The main challenges of this condition are in the vague symptoms and in some patients, it may be the first presentation of diabetes. Fortunately, diagnosing DKA has been easier due to easier access to lab tests and the guidelines of diagnosis. Moreover, management of these cases has been the same with vigorous fluid, insulin, and electrolyte replacement therapy as the cornerstone.
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