Alonso GT, et al. - Via involving Colorado residents < 18 years old who were diagnosed with type 1 diabetes (T1D) from 2010 to 2017 and subsequently followed at the Barbara Davis Center for Diabetes, researchers analyzed trends in diabetic ketoacidosis (DKA) at diagnosis of T1D at a large pediatric diabetes center between 2010 and 2017, overlapping with the Affordable Care Act’s overhaul of US healthcare. They used logistic regression models to test connections among age, gender, race/ethnicity, insurance, language, year of diagnosis, and rural/nonrural residence and DKA at diagnosis. The inclusion criteria were met by 2,429 individuals. Data reported that the rate of DKA increased from 41 to 58% from 2010 to 2017. It rose from 35.3% to 59.6% among private insurance patients but remained unchanged among public insurance children. In the multivariable model, public insurance, rural address, and HbA1c were positively linked to DKA, while age, race/ethnicity, gender, and primary language were not. Patients with private insurance were driven by the rise in the rate of DKA in patients with newly diagnosed T1D. It occurred in a time of rising health insurance coverage, paradoxically. To understand the factors that drive these changes, further study is required.