Approximately 35-45 % of children and adolescents suffer from diabetic ketoacidosis (DKA) at diagnosis.The incidence is 4.6 to 8 episodes per 1.000 patients suffering from diabetes, and it is the main cause of Morbidity and Mortality in type 1 diabetic patients.Mortality is principally due to cerebral edema, and only few deaths are related to other causes.Cerebral edema occurred in nearly 0.3 of 1% of all diabetic ketoacidosis cases, and its etiology is not clearly understood ,although different hypothesis have been proposed, the ideal treatment is not well established.It will be discussed different protocols of insulin infusions and intravenous fluid regimens.Risk factors for the development of DKA and cerebral edema are also described.It will be a main goal of type 1 diabetic patients care to prevent DKA.