Consistently high incidence of diabetic ketoacidosis in children with newly diagnosed type 1 diabetes

To the Editor: The incidence of type 1 diabetes (T1D) in children is rising globally, including in Australia.1 Diabetic ketoacidosis (DKA) is the leading cause of diabetes-related deaths in children.2 Clinical manifestations of DKA include dehydration; rapid, deep, sighing (Kussmaul respiration); nausea; vomiting; abdominal pain and a reduced level of consciousness.2 There is an inverse relationship between the frequency of presentation with DKA and background incidence of T1D in a given country,3 suggesting that the diagnosis is more likely to be considered earlier in countries with higher incidence of T1D, such as Australia.