Diabetic ketoacidosis is a common acute complication of insulin-dependent diabetes mellitus. It is defined as the triad of hyperglycemia, acidosis and ketosis. Once diabetic ketoacidosis is suspected, the diagnosis should be established rapidly and treatment initiated. Fluid administration, insulin therapy and correction of metabolic abnormalities are the cornerstones of therapy. Treatment of any underlying illnesses, particularly infection, is also essential to ensure the best possible outcome. Appropriate patient monitoring allows the clinician to assess therapy and make necessary adjustments.