Diabetic ketoacidosis (DKA) is a complication of type 1, or "insulin-dependent," diabetes (T1DM) and is defined by a high blood glucose level (over 200 mg/dL) coupled with severe acidosis. Children with T1DM lack adequate insulin production. Without insulin, glucose cannot be used by cells to produce energy and blood glucose levels increase. As a result, the body breaks down fat tissue for adequate energy production. This results in ketone and acid production, and ultimately DKA. Often times DKA is present at the time of diabetes diagnosis. Recent estimates suggest that nearly 30% of children that present with DKA are newly diagnosed with diabetes. DKA can also occur as a result of poorly controlled T1DM or poor adherence to insulin therapy. It is common for such patients to have recurrent episodes of DKA, which may lead to permanent brain injury.