The aim of this study was to assess the impact of the COVID-19 pandemic on hospital admissions for diabetes-related acute complications in Italy. Discharge records of 623 patients admitted to Cardarelli Hospital for diabetic emergencies in 2019 (pre-COVID-19 period) and 2020 (COVID-19 period) were analyzed. Prevention Quality Indicators (PQIs) were used to identify potentially preventable diabetes-related hospitalizations, and a logistic regression model was used to identify factors that influenced the likelihood of hospitalization for diabetic patients, including APR-DRG weight, age, sex, length of stay, and PQI classification. APR-DRG weight, long-term diabetes complications, and LOS by long-term diabetes complications were found to be significantly associated with 2020 admissions. The COVID-19 pandemic may have led to more severe cases of diabetes being admitted to hospital, while less severe cases may have been postponed or treated outside the hospital. The study is limited by its small sample size and monocentric analysis, and further research is needed to better understand the interactions between COVID-19 and emergency diabetes hospitalizations.