We read with great interest the recent study by Sebastian-Valles F et al. published in the European Journal of Internal Medicine, titled " Pre- and in-hospital lactate ratio as a predictor of mortality in severe diabetic ketoacidosis: a multicenter prospective cohort study" [1]. The authors are to be commended for their prospective, multicenter effort to address the crucial, yet unmet, clinical need for early and accurate risk stratification in patients with severe diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).
