Shao P, Guo S, Li G, et al. - Researchers conducted this retrospective case-control study to assess metabolic parameters like leukocyte count, blood biochemistry, liver function, kidney function, blood lipids, and C-peptide levels in relation to risk of euthyroid sick syndrome (ESS), also known as non-thyroidal illness syndrome, among children with type 1 diabetes admitted for management of diabetic ketoacidosis (DKA), diabetic ketoacidosis (DK), or acute hyperglycemia. Ninety-eight DKA and 96 DK pediatric patients were chosen from hospital records. Compared with the euthyroid group, the ESS group had a higher level of white blood cell count, plasma glucose, beta-hydroxybutyric acid (β-HB), triglyceride, anion gap (AG), glycosylated hemoglobin (HbA1c) and a lower level of HCO₃⁻, prealbumin, and albumin. The most important factor deciding euthyroid or ESS on logistic regression analysis was HCO₃⁻ level. In children with DKA/DK, lower levels of free thyroid hormones and the occurrence of ESS were correlated with a higher degree of acidosis.