We present a case of a 3-year-old girl with previously diagnosed type 1 diabetes mellitus (T1DM) who was admitted in an unconscious state with severe diabetic ketoacidosis (DKA), lactic acidosis, and coma. The condition was complicated by profound dehydration, leukemoid reaction of neutrophilic type, and reactive thrombocytosis. Early intensive care management, mechanical ventilation, and insulin therapy led to stabilization and gradual recovery. This case highlights the critical importance of early recognition, aggressive management, and multidisciplinary care in pediatric patients with complicated DKA.