Objectives <p>To estimate the prevalence of Severe Hypoglycemia (SH) and (Diabetic Ketoacidosis) DKA in adults, adolescents, and children with Type 1 Diabetes (T1DM), as well as the risk factors associated with their occurrence.</p> Methods <p>Records from the Madinah Diabetic Center and hospitals were reviewed retrospectively to evaluate the clinical and laboratory data of 700 adults, adolescents, and children who presented with T1DM associated with DKA or SH between 2019 and 2022.</p> Results <p>40.6% were diagnosed with DKA and 59.4% with SH. Fasting blood glucose (FBG), HbA1c, and triglycerides were raised in most individuals. Individuals with DKA were divided by severity. 24.3% of adults, 31.7% of children, and 44% of adolescents had DKA out of 700 patients with T1DM. In addition, 50.7% of adolescents and 27.1% of adults are moderate, while 38.8% of children are severe. Young age, female gender, raised FBG, HbA1c, and triglycerides were associated with severe DKA. Based on severity, SH patients were divided into classes; 12.4% of children and 11.9% of adolescents are moderate, compared to 74.3% of adults. 18% of the cases are severe, including 51.2% adults. The risk of developing SH was considerably reduced in those with higher levels of fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and body mass index (BMI). However, there was a strong and positive association between older age and increased risk of SH.</p> Conclusion <p>Diabetic ketoacidosis (DKA) and severe hypoglycemia (SH) were prevalent among patients diagnosed with T1DM in the region under study. Children and adolescents who have high fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and lipid levels are at a heightened risk of developing DKA. Nevertheless, SH frequently manifests in adult individuals (as they age and the length of their diabetes increases) who have low levels of fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) due to diabetes.</p>