SynthesisBMJ open2017
Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review.
Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 110 papers, 6 of them syntheses that pooled it.
What it found
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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.
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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.
Who cites it
110 citing papers in PubMed, 6 syntheses or guidelines pooled it, 244 citations in OpenAlex.
- Electronic Glycemic Management Systems Versus Conventional Insulin Infusion Protocols in Diabetic Ketoacidosis: A Systematic Review and Meta-Analysis of Non-Randomized Studies.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Subcutaneous fast-acting insulin analogues ± long-acting insulin vs IV insulin infusion in DKA: updated meta-analysis of randomised trials.Endocrine · 2025Pooled it
- Burden of diabetic ketoacidosis and its predictors among diabetic patients in Ethiopia: Systematic review and meta-analysis.PloS one · 2025Pooled it
- Magnitude, risk factors and economic impacts of diabetic emergencies in developing countries: A systematic review.PloS one · 2025Pooled it
- Health and well-being issues of Nepalese migrant workers in the Gulf Cooperation Council countries and Malaysia: a systematic review.BMJ open · 2020Pooled it
- Concurrent presentation of thyroid storm and diabetic ketoacidosis: a systematic review of previously reported cases.BMC endocrine disorders · 2019Pooled it
- Use of Technology in Older Adults with Type 1 Diabetes: Clinical Characteristics and Glycemic Metrics.Diabetes technology & therapeutics · 2022Trial
- Diabetic Ketoacidosis and Related Events With Sotagliflozin Added to Insulin in Adults With Type 1 Diabetes: A Pooled Analysis of the inTandem 1 and 2 Studies.Diabetes care · 2020Trial
- Awareness of Diabetic Ketoacidosis and Associated Factors Among Adults with Diabetes or a Family Member with Diabetes in Jazan, Saudi Arabia.Healthcare (Basel, Switzerland) · 2026Article
- Trajectory of Kidney Function in T1D over Time: A Scoping Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Review
- Trends in Potentially Avoidable Hospitalisations Among People With Diabetes in Ireland; 2015-2024.Diabetes, obesity & metabolism · 2026Article
- Clinical profile, treatment outcomes of burn injuries and their associated factors among patients admitted in HarME-center, HFCSH, Harar, Eastern Ethiopia.International journal of emergency medicine · 2026Article
- Biochemical profiles and precipitating factors of diabetic ketoacidosis among type 1 and type 2 diabetes patients: a retrospective analysis from Syria.BMC endocrine disorders · 2026Article
- Hypophosphatemia in Diabetic Ketoacidosis During Intensive Care Admission.Medical sciences (Basel, Switzerland) · 2026Article
- Robustness of Joint Over Separate Models for Investigating Predictors of Blood Sugar Level and Time to First Remission Among Type I Diabetic Patients Under Treatment; a Retrospective Study Design.Health science reports · 2026Article
- The Development and Validation of Multivariable Electronic Health Record-Based Models to Predict Diabetic Ketoacidosis-Related Hospitalizations for Adults with Type 1 Diabetes.Diabetes technology & therapeutics · 2026Article
- Tubed or tubeless insulin pumps? A retrospective real-world analysis of national French health data.BMJ open diabetes research & care · 2026Article
- Incidence and predictors of diabetic ketoacidosis among adults with type 1 diabetes in Northwest, Ethiopia, 2023: a retrospective cohort study.BMC public health · 2026Article
- Prevalence and outcomes of DKA in type 1 and type 2 DM patients treated and not treated with SGLT-2 inhibitors.Diabetic medicine : a journal of the British Diabetic Association · 2026Article
- Insulin Delivery Hardware: Pumps and Pens.Diabetes technology & therapeutics · 2026Article
50 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo summarise incidence and prevalence of diabetic ketoacidosis (DKA) in adults with type 1 diabetes (T1D) for the overall patient population and different subgroups (age, sex, geographical region, ethnicity and type of insulin administration).
designSystematic literature review (SLR). DATA SOURCES: Medline (via PubMed) and Embase (1 January 2000 to 23 June 2016). STUDY SELECTION: Peer-reviewed observational studies with reported data on the incidence or prevalence of DKA in T1D adults were included. A single reviewer completed the study screening and selection process and a second reviewer performed an additional screening of approximately 20% of the publications; two reviewers independently conducted the quality assessment; the results were narratively synthesised.
resultsOut of 1082 articles, 19 met the inclusion and exclusion criteria, with two additional studies identified that did not specify the patient age range and are therefore not included in the SLR. Overall, eight studies reported incidence with a range of 0-56 per 1000 person-years (PYs), with one outlying study reporting an incidence of 263 per 1000 PYs. Eleven studies reported prevalence with a range of 0-128 per 1000 people. Prevalence of DKA decreased with increasing age. Subgroup analyses were performed using data from no more than two studies per subgroup. There was a higher prevalence of DKA reported in women, non-whites and patients treated with insulin injections compared with men, whites and patients using continuous subcutaneous insulin infusion pumps, respectively.
conclusionsTo our knowledge, this is the first SLR on the epidemiology of DKA in T1D adults. Despite an increasing prevalence of T1D in recent years, DKA in adults has been poorly characterised. In an era when the benefit-risk profiles of new antidiabetic therapies are being evaluated, including the potential risk of DKA, there is a clear need to better elucidate the expected rate of DKA among T1D adults.
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Registered trials
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.