Previous studies of rodent type 1 diabetes models reported upregulation of myocardial mRNA levels of HMGCS2 in mice51 and both its mRNA and protein levels in rats.52 However, these studies did not determine enzymatic activity, posttranslational modification, or the relative changes in FAO, glucose metabolism, or citric acid cycle changes at the metabolite level, essential to pinpoint the transition to ketogenesis. This evidence concerns the gene HMGCS2 and type 1 diabetes mellitus.