Diabetic ketoacidosis and hyperosmolar syndrome are the most common life-threatening complications of the growing epidemic of diabetes in the US. Timely recognition is essential to initiating appropriate management in the ED. Careful attention to fluid administration, electrolyte replacement, and insulin therapy is essential to reducing hospital length of stay and complications. During this case-based interactive discussion, the speaker will review cases of diabetic emergencies. Important similarities and differences in pathophysiology and management will be reviewed. Best evidence will be summarized in practical strategies to bring back to your ED.