**1. Introduction**

A chronic autoimmune destruction of the pancreatic beta cells results in decreasing endoge‐ nous insulin secretion and the clinical manifestation of type 1 diabetes mellitus (T1DM). The clinical onset of the disease is often acute in children and adolescents and diabetic ketoaci‐ dosis (DKA) is present in 20-74% of the patients [1-7]. DKA is a serious condition that re‐ quiring immediate intervention. Even with appropriate intervention, DKA is associated with significant morbidity and possible mortality in diabetic patients in the pediatric age group [8]. Young age and female sex have been associated with an increased frequency of DKA [3,9]. The triad of uncontrolled hyperglycemia, metabolic acidosis and increased total body ketone concentration characterizes DKA [10]. In addition to possible acute complica‐ tions, it may also influence the later outcome of diabetes [11].
