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Diabetes is a major cause of morbidity and mortality. It is therefore a costly disease for the patient, families and society. The aim is to study the epidemiological aspects, to report the factors at the origin of the decompensation and the evolutionary modalities in order to improve the care in Mbujimayi (DRC). The frequency of diabetic ketoacidosis was 25.5 of cases in the Internal Medicine department. For all our patients, ketoacidosis predominates in subjects under 40 years of age. Ketoacidosis occurs in any diabetic patient, the average age of our patients was 42.3 Plus or minus 3.6 years with the target age range between 56-70 years, the male sex was more concerned with 54.4 against 45, 6 for the female sex whose clinic is superposable to that described by the literature. Infections occupy the first place as a triggering factor in our study with 64.6 and followed by treatment discontinuation 13.9 . The evolution is marked by a mortality of 25 cases or 31.64 .