Evidence map›Paper›PMID 24855156›Full record

ArticleDiabetes care2014

Neurological consequences of diabetic ketoacidosis at initial presentation of type 1 diabetes in a prospective cohort study of children.

Fergus J Cameron, Shannon E Scratch, Caroline Nadebaum, Elisabeth A Northam, Ildiko Koves, Juliet Jennings, Kristina Finney, Jeffrey J Neil, R Mark Wellard, Mark Mackay and 2 more

Open access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 2 pooled it
–field-weighted citation impact, top 95% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.

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  9. Agreement between directly reported and recalled EQ-5D-5 L outcomes after an acute health event: a prospective cohort study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Fergus J CameronDepartment of Endocrinology and Diabetes, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia fergus.cameron@rch.org.au.
Shannon E ScratchDepartment of Endocrinology and Diabetes, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia.
Caroline NadebaumDepartment of Endocrinology and Diabetes, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia.
Elisabeth A NorthamDepartment of Psychology, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia.
Ildiko KovesDepartment of Endocrinology and Diabetes, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia.
Juliet JenningsDepartment of Endocrinology and Diabetes, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia.
Kristina FinneyWashington University, St. Louis, MO.
Jeffrey J NeilWashington University, St. Louis, MO.
R Mark WellardQueensland University of Technology, Brisbane, QLD, Australia.
Mark MackayDepartment of Neurology, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia.
Terrie E InderWashington University, St. Louis, MO.
DKA Brain Injury Study Group
Royal Children's Hospital · AUWashington University in St. Louis · USQueensland University of Technology · AU

Funding

Washington University Intellectual and Developmental Disabilities Research CenterP30HD062171 · NICHD · WASHINGTON UNIVERSITY · PI NEIL, JEFFREY J. · 2010 to 2014
$4.3M
NICHD NIH HHS P30 HD062171NICHD NIH HHS P30-HD-062171
6 · The paper itself

Abstract

objectiveTo investigate the impact of new-onset diabetic ketoacidosis (DKA) during childhood on brain morphology and function. RESEARCH DESIGN AND

methodsPatients aged 6-18 years with and without DKA at diagnosis were studied at four time points: <48 h, 5 days, 28 days, and 6 months postdiagnosis. Patients underwent magnetic resonance imaging (MRI) and spectroscopy with cognitive assessment at each time point. Relationships between clinical characteristics at presentation and MRI and neurologic outcomes were examined using multiple linear regression, repeated-measures, and ANCOVA analyses.

resultsThirty-six DKA and 59 non-DKA patients were recruited between 2004 and 2009. With DKA, cerebral white matter showed the greatest alterations with increased total white matter volume and higher mean diffusivity in the frontal, temporal, and parietal white matter. Total white matter volume decreased over the first 6 months. For gray matter in DKA patients, total volume was lower at baseline and increased over 6 months. Lower levels of N-acetylaspartate were noted at baseline in the frontal gray matter and basal ganglia. Mental state scores were lower at baseline and at 5 days. Of note, although changes in total and regional brain volumes over the first 5 days resolved, they were associated with poorer delayed memory recall and poorer sustained and divided attention at 6 months. Age at time of presentation and pH level were predictors of neuroimaging and functional outcomes.

conclusionsDKA at type 1 diabetes diagnosis results in morphologic and functional brain changes. These changes are associated with adverse neurocognitive outcomes in the medium term.

Indexed as

AdolescentAspartic AcidBrainChildCognition DisordersDiabetes Mellitus, Type 1Diabetic KetoacidosisFemaleHumansLinear ModelsLongitudinal StudiesMagnetic Resonance ImagingMaleMental RecallProspective StudiesAspartic AcidN-acetylaspartate

Identifiers

PMID24855156
PMCPMC4179516
OpenAlexW1584025224

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.