Laboratory investigations identified severe DKA (random glucose level of 450mg/dl, serum bicarbonate level of 2 mmol/l and pH of 6) as well as severe hypernatremia of 170 mmol/l which were treated in ED with 2 L of sodium chloride 0.9% followed by 150ml/hr infusion and free water nasogastric flushes, 100ml of bicarbonate, 20mg enoxaparin SQ, 10U of insulin glargine followed by 5U/hr insulin infusion, pantoprazole and 2g of ceftriaxone intravenously. Here, INS is linked to Hypernatremia.