The authors present an account on their experience with treatment of diabetic ketoacidosis with small (physiological) doses of insulin in a group of patients who were hospitalized in the course of four years at the intensive metabolic care unit. Diabetic ketoacidosis is in spite of therapeutic advances still a serious matter. It calls for monitoring of vital functions, intensive treatment and regular checks of laboratory indicators. Treatment of diabetic ketoacidosis with small (physiological) insulin doses proved effective and safe and the incidence of complications was minimal.