The pharmacologic approach to the management of DKA and HHNS involves the use of insulin, fluids, and electrolytes. Essential to the successful treatment of DKA and HHNS is a carefully planned post-intensive-care transition period. This period is based on the understanding that insulin therapy is never interrupted in patients with type 1 diabetes and the transition to insulin and/or oral hypoglycemic therapy in type 2 patients is strategically planned. The use of acute adjuvant insulin-glucose therapy in acute coronary syndromes and cardiac surgeries can result in decrease in overall morbidity and mortality in patients with diabetes. Ultimately, however, the major approaches to the treatment of diabetes is primary prevention of diabetes itself and the secondary prevention of complications through vigorous glucose control.