There are no randomised studies assessing the impact of the location of care (intensive care unit, high dependency unit, emergency medical unit, diabetes specialty ward, or general medical ward) on the outcome of DKA or HHS. Accordingly this choice must be based on the available hospital resources and known prognostic indicators. Patients with DKA need intensive monitoring, and therapy with prompt access to diagnostic and laboratory services and these must be available whichever management site is chosen. Interestingly, the use of standardised written guidelines appear to be more important in determining outcome than the type of hospital or the specialty of the attending physician,9 14 18 55–58 though implementation of the guidelines may not always be as straightforward as it sounds.59 In these studies,9 14 18 55–58 and in a UK study13 mortality rates for DKA were ,5% and those for HHS