Diabetic ketoacidosis is a life-threatening complication associated with type 1 diabetes (T1D). Recent evidence suggests that SARS-CoV-2 could trigger diabetic ketoacidosis in type 1 diabetes susceptibility and previous insulitis; however, the data on SARS-CoV-2-infected patients with diabetic ketoacidosis as their type 1 diabetes are still limited. We report a 13-year-old Latinamerican male with symptoms and laboratory tests diagnostic of diabetic ketoacidosis and positive SARS-CoV-2 reverse transcription polymerase chain reaction, who required mild COVID-19 care management, fluid resuscitation, and insulin infusion at a regular dose, without further complications after the acute infection. Clinical/biochemical improvement allowed outpatient endocrinology follow-up with insulin therapy and continuous glucose monitoring. To our knowledge, we report the first case of diabetic ketoacidosis as the debut of type 1 diabetes in a Colombian pediatric patient with concurrent SARS-CoV-2 infection. Therefore, this report aims to contribute to the global research on SARS-CoV-2 and diabetic ketoacidosis and discuss the approach to these concomitant pathologies.

Healthcare institutions are organizations driven to provide medical assistance at a certain level of quality service and safety. To achieve the recognition of excellence, these entities can undergo accreditations and comparisons with other institutions of their kind through ranking systems in order to validate patient, organizational, and academic institutional standards. Usually, the goal is to obtain prestige and recognition as well as positive feedback toward the institution, motivating improvement. In this scenario, the manager's role is to communicate these results and propose strategies to maintain or increase healthcare quality. The following article discusses the fundamentals of the processes of accreditation and ranking systems, the importance of health managers on the complexity of these processes and on achieving an institution's goals and vision, but also intends to provide a critical view toward the desire for prestige a hospital envisions within the feedback when its biggest aim should be directed to improve in benefit of the patients and workforce conditions.