Diabetes Mellitus remains a challenging disease despite allresearch and effort to control it. The vascular complicationsremain the main cause of death and morbidity despite efforts tocontrol the blood sugar and to scan for early detection andmanagement. Diabetic patients are admitted to critical care forvarious reasons: Acute Metabolic insult (ketoacidosis,hypoglycemia, Hyperosmolar coma) , acute coronarysyndrome, acute peripheral ischemia, Acute stroke and TIAS, serious infection (pneumonia, cellulites, adult respiratorydistress syndrome and septicemia).