The objective of our work is to study the relationship between glycemic control and metabolic outcomes (severe hypoglycemia and ketoacidosis).Material and Methods: Among 538 diabetics, we identified 69 patients with hypoglycemic or ketoacid comas. The HA1c assay was performed on a DCA 2000 analyzer.Result: The incidence of acidotis coma is 0.93% and the incidence of hypoglycemic coma is 12%. The patients who had an acidotis coma had an HbA1c level between 6.5 and 11.5% with major hyperglycemia (3g/L to >5g/L). 63 diabetics have a hypoglycemic coma with duration of diabetes < 6 years. The number of hypoglycemic comas is inversely proportional to the duration of diabetes. One is more likely to have hypoglycemic comas for HbA1c levels < 7.5%, compared with HbA1c levels 7.5% and 8 or HbA1c levels > 8%. 45% of patients increased their HbA1c levels versus 35% who decreased it in the last quarter compared to the previous quarter.Conclusion: This original work shows that there is an inverse relationship between the incidence of severe hypoglycemia and quarterly HbA1c values. A low HbA1c level exposes the T1DM child to a high risk of hypoglycemic coma. Thus, the fear of severe hypoglycemia would be at the origin of an alteration of the patient's glycemic balance and the high HbA1c values. Thus, multidisciplinary management (adequate treatment and initial therapeutic education) will help avoid metabolic complications in diabetics.