Acute complications of diabetes include diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic nonketotic syndrome (HHS), and hypoglycemia. DKA and HHS occurs when there is insufficient insulin to transport glucose into the cells. The difference between DKA and HHS is that in HHS an individual has just enough insulin to prevent ketoacidosis but not enough to prevent osmotic diuresis, hyperglycemia, and extracellular fluid depletion (Robbins, Shaw, & Lewis, 2010). DKA is more common in type 1 diabetes mellitus (DM1) clients because these individuals tend to have an absence of insulin, where type 2 diabetes mellitus clients (DM2) are more likely to experience HHS because they still have some ability to produce trace amounts of insulin (Robbins et al., 2010). Hypoglycemia is when a blood glucose is below 4mmol/L, and occurs more frequently in DM1 due to insulin therapy than DM2 who are not insulin dependent (Fowler, 2009; Frier, 2014). That said DM2 clients who are insulin dependent are also experience frequent hypoglycemic events while sleeping (Frier, 2014). Hypoglycemia occurs more frequently in clients taking insulin than those taking oral hypoglycemics because of the mechanism of action and the way its metabolized (Skidmore-Roth, 2013). Regardless of the type of diabetes an individual has, the maintenance of blood glucose levels significantly impacts the development and severity of long term complications (Fowler, 2011). Macro-vascular complications affect the large
