Duca LM, et al. - Experts aspired to explore whether the presence of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) was associated with less favorable hemoglobin A1c (HbA1c) trajectories over time. For up to 13 [median 8 (IQR 6-9)] years post-diagnosis, the SEARCH for Diabetes in Youth study of 1396 youth aged <20 years with newly diagnosed T1D were followed. They observed that HbA1c levels were significantly higher in youth with T1D diagnosed in DKA compared to those who were not at baseline. Findings suggested an association of DKA at T1D diagnosis with worsening glycemic control over time, irrespective of demographic, socioeconomic and treatment-related factors and baseline fasting C-peptide.