Many situations can lead to ketosis/ketoacidosis (failure of or insufficient insulin delivery, sick days, very low carb diets, SGLT2i use, high-intensity exercise, hyperemesis gravidarum, excessive alcohol consumption), but yet many people with T1D do not even own home ketone monitoring strips, possibly due to the high cost of these strips, and in one third of cases these strips have exceeded their expiry date (16). This evidence concerns the gene INS and hyperemesis gravidarum.