Inclusion Criteria:  There are no definitive criteria for diagnosing DKA.3 Thus, using the criteria employed by Self et al.8 and the Diabetes Canada guidelines3 we will include ED patients ≥18 years with a clinical diagnosis and laboratory values consistent with DKA, including:  plasma glucose concentration ≥14mmol/L plasma bicarbonate concentration ≤18mmol/L and/or blood pH ≤7.30 calculated anion gap >10mmol/L presence of ketones/beta-hydroxybutyrate in serum and/or urine  Exclusion Criteria:  We will exclude patients who:  Are initially seen at another ED and transferred to LHSC for care and/or admission Receive >1L of IV fluid prior to enrolment (e.g. pre-hospital by EMS or while waiting to be seen) - this may cause study contamination Are initially enrolled due to clinical suspicion of DKA based on elevated point-of-care glucose, but ultimately do not meet clinical/laboratory criteria for DKA (e.g. "hyperglycemia" only) Have euglycemic DKA (generally those on SGLT-2 inhibitors)