Objectives To analyze the occurrence of DKA in Chinese adults. Methods and Patients We retrospectively reviewed the medical records of adults presenting with DKA in a tertiary referral center from January 1992 to December 1997, We classified these patients into 3 groups: type 1, type 2 and new-onset diabetes, Clinical features and follow-up treatment were analyzed, Results One hundred and twenty patients with 141 episodes of DKA were included; 77 episodes (54,6%) were classified as being caused by type 2, 32 (22.7%) by type I and 32 (22.7%) by new-onset DM. The average age of type 2 patients was significantly higher. Of the 25 new-onset patients with follow-up for at Beast 12 months, PI were not taking insulin, Of these 11 patients;, 6 had a family history of Dha and 5 had BMI greater than 26,4 kg/m(2), The fasting plasma C-peptide values at various times of follow-up varied from 2.3 to 9.5 ng/ml in 6 of the 11 DKA-onset patients. Conclusion In type 2 patients, the occurrence of DKA is usually associated with old age and another severe illness. "DKA-onset type 2 DM" reported in African-Americans and In Japanese is also observed in Chinese.