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Acute complications of diabetes are life-treatening conditions requiring immediate medical assistance. Although they are responsible for a rather small proportion of deaths in diabetic patients, the mortality rates associated with these complications are fairly high. Acute problems of diabetes include diabetic ketoacidosis and diabetic aketotic hyperosmolar syndrome, which are two forms of severe uncontrolled diabetes and hypoglycemia, which is a iatrogenic complication. In a nonhospital setting, immediate identification of causes of disturbed consciousness in a diabetic patient should be based on the clinical picture and blood glucose levels determined by testing papers. Patients with diabetic ketoacidosis and diabetic aketotic hyperosmolar syndrome should be admitted to hospital, while hypoglycemia should be managed at the scene.