INS and type 1 diabetes mellitus: Figure 3, highlights that small children (<2 years), those with misdiagnosis, or positive antibodies to insulin and islet cells had more severe presentations as most of them presented with moderate to severe DKA. These antibodies were detected with statistically higher percentage in patients with moderate to severe DKA as compared to other groups, (P < 0.001). Table 4 showed that 80.8% of patients were cow's milk fed which could raise the issue of early cow's milk feeding as a risk factor for T1DM.