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Background: Diabetes Mellitus (DM) affects 12.3% of the U.S. population and is responsible for $245 billion in annual costs. Knowledge about their disease is an important part of patients' self-management. Objective: The objective of this study was to describe the baseline level of knowledge of patients with diabetes in this emergency department (ED), including behaviors related to healthy eating such as carbohydrate counting (CC). Methods: This was a cross sectional interview survey conducted at an academic tertiary center. An 8-item survey was developed to assess areas of diabetes self-care and carbohydrate knowledge. Trained research assistants approached all medically stable, non-pregnant ED patients with a past medical history of diabetes for participation. Descriptive statistics and ANOVA analysis were used. Results: Of the 115 patients approached, 98 were willing to participate; 54% were using insulin and 68% were female. The average age was 55 (SD +/-14) years and diagnosed for an average of 12 (SD +/-10) years. Fifty three percent did not check their morning blood sugar. Only 20% could accurately state the target hemoglobin A1c. While 48% of participants could relate the importance of carbohydrates to blood sugar, only 5% could state the number of grams of carbohydrates in a slice of bread. Only 1 participant correctly answered all 4 of the carbohydrate questions. Higher education and more visits with a nutritionist were associated with carbohydrate knowledge. Conclusions: Carbohydrate knowledge among this ED population was poor. Opportunities exist for patient education.