The presence of hyperkalemia in diabetes is seen in several conditions. One is an acute complication of diabetes, such as diabetic ketoacidosis. Acute kidney injury caused by severe dehydration and reduced blood volume leads to decreased kidney function and reduced potassium excretion by the kidneys. At the same time, acidosis also causes potassium ions to be transferred from intracellular to extracellular, and multiple factors cause hyperkalemia in patients with diabetic ketoacidosis. Hyperkalemia will gradually correct with fluid replacement, correction of circulating blood volume deficit, and correction of acidosis. Another condition is the development of chronic complications of diabetes, such as diabetic nephropathy, which progresses to the final stage of uremia, severely affecting the renal excretion of potassium and leading to hyperkalemia. It is also possible that in patients with diabetic nephropathy, the blood potassium can still be maintained as normal, although the kidney function is diminished. Hyperkalemia may also be caused by the use of drugs with potassium-preserving effects, such as angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and potassium-preserving and diuretic drugs.