Background; As part of the, ‘CNC Strategic Leadership Project’ at Prince of Wales Hospital, a review of the clinical notes of diabetic patients, who re-present to the emergency department is being undertaken.  Preliminary findings of the first 11 patients have been identified. Aim; To identify commonalities between patients re-presenting to hospital, as the basis to develop processes which will aid staff in assisting patients to avoid hospital re-presentation. Method; Patients with diabetes re-presenting to the Emergency Department in 2014 and 2015 were identified using, Electronic Medical Record ‘patient flow reports’ and their clinical notes were viewed. Information on ; type and duration of diabetes, time between re-presentations, age range, number of co-morbidities, HbA1cs , reason for re-presentation, type of insulin regimen, psycho/social aspects, whether patient is known to the  Diabetes Centre staff. Results; 54 presentations of 11 patients were reviewed. Age range; 42yrs to 82yrs. Time between presentations; 1 day to 5months. 10 patients had type2 diabetes, and 1 had type1 diabetes. Duration of diabetes was unknown to >30yrs. All patients were on insulin. Reasons for presentation were frequently not for diabetes per se. Reasons included; chest pain, falls, infections, , limb pain, gastroenteritis, confusion, loss of vision, suicide ideation, pulmonary oedema, perianal bleeding and malaena as well as hypoglycaemia and hyperglycaemia. HbA1c; 49mmol/L (6.6%) to 126mmol/L (13.7%).  Patients had 2 to 10 comorbidities. All but 1 patient had psychiatric and cognitive problems including; developmental delay 3, schizophrenia 2, bipolar disorder 2, depression 2, dementia 4, and low MMSE score 1.  8 patients were known to the diabetes centre 8. Conclusion; Diabetes was often not listed as the reason for hospital presentation. Mental illness and dementia affected 10 out of the 11 patients, impacting negatively on health and glycaemic control. Patients had difficulties coping with medication taking, diabetes self-care and healthy lifestyle. The project continues and further studies are planned to look into the issues of diabetic patients re-presenting to hospital.