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Diabetic ketoacidosis (DKA) is a potentially life-threatening metabolic disorder that can occur with manifestation of type 1 diabetes mellitus (T1D). The aim of this study was to analyze the incidence of DKA at the time of the diagnosis of T1D in childhood and adolescence, the risk factors, and regional approaches to reduce the incidence of ketoacidosis. We investigated the proportion of patients under 18 years of age with DKA (defined as pH 7.3, severe DKA pH 7.1) at the manifestation of T1D in Germany in the period 2000-2019,
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