INS and diabetes mellitus: We were unable to account for the presence of coexisting mental health conditions, which have been shown to be associated with readmissions for DKA in children.7,64 Implicit bias by clinicians may further influence treatment decisions, including hospitalization.39,65 Third, we were unable to reliably account for use of diabetes technology, which has been associated with lower rates of DKA.50,66,67 For example, the prevalence of the ICD-10 code for insulin pump use (Z96.41) in PHIS was only 3% and varied significantly by hospital from less than 1% to 18%.